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NPI Code Detail

MEDICARE: OPEN GATE THERAPY, LLC

MEDICARE: OPEN GATE THERAPY, 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
1101Y00000XCounselor

General Provider Information

NPI Number : 1629905898
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPEN GATE THERAPY, LLC
Provider Business Mailing Address
First Line : 1453 29TH AVE STE 6
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4949
Country : US
Telephone Number : 402-910-3884
Fax Number :
Provider Business Practice Location Address
First Line : 1453 29TH AVE STE 6
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4949
Country : US
Telephone Number : 402-910-3884
Fax Number :
Authorized Official
Title or Position : LICENSED INDEPENDENT MENTAL HEALTH
Name : JULIANNE LAUDENKLOS
Credential : LIMHP
Telephone Number : 402-910-3884
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “OPEN GATE THERAPY, LLC ” Practice Location

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