MEDICARE: MRS. CHRISTINA BROEKEMEIER LIMHP,LMHP,MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	7624	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	774453000	OTHER	NE	MAGELLAN MIS NUMBER

General Provider Information

NPI Number	:	1417932393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINA BROEKEMEIER LIMHP,LMHP,MA

Provider Business Mailing Address
First Line	:	1406 FORT CROOK RD S STE 401
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005-2980
Country	:	US
Telephone Number	:	402-350-1968
Fax Number	:	402-292-0144

Provider Business Practice Location Address
First Line	:	1406 FORT CROOK RD S STE 401
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005-2980
Country	:	US
Telephone Number	:	402-350-1968
Fax Number	:	402-292-0144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	12/19/2022

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