MEDICARE: CHRISTINA BROEKEMEIER LIMHP LLC

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

General Provider Information

NPI Number	:	1598475451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINA BROEKEMEIER LIMHP LLC

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	:	OWNER/MENTAL HEALTH PROVIDER
Name	:	MRS. CHRISTINA BROEKEMEIER
Credential	:	LIMHP
Telephone Number	:	402-350-1968

Provider Enumeration Date	:	12/01/2022
Last Update Date	:	12/01/2022

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