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1679517684

NPI Code Detail

MEDICARE: TELECARE MENTAL HEALTH SERVICES OF NEBRASKA, INC

MEDICARE: TELECARE MENTAL HEALTH SERVICES OF NEBRASKA, INC

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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
2	2084P0802X	Addiction Psychiatry Physician
3	251S00000X	Community/Behavioral Health Agency
4	320800000X	Mental Illness Community Based Residential Treatment Facility

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	NA1928	OTHER	NE	MEDICARE PTAN

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679517684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELECARE MENTAL HEALTH SERVICES OF NEBRASKA, INC

Provider Business Mailing Address
First Line	:	1080 MARINA VILLAGE PKWY
Second Line	:	SUITE 100
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1078
Country	:	US
Telephone Number	:	510-337-7950
Fax Number	:	510-337-7969

Provider Business Practice Location Address
First Line	:	2231 LINCOLN RD
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005-3907
Country	:	US
Telephone Number	:	402-291-1203
Fax Number	:	402-291-3915

Authorized Official
Title or Position	:	PROVIDER RELATIONS SUPERVISOR
Name	:	LORENA LOPEZ
Credential	:
Telephone Number	:	510-337-7950

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	02/10/2025

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2231 LINCOLN RD
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1780990432 — GLENDA LORENZEN RN
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BELLEVUE, NE
68005-3907

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1568779122 — KAREN M. NOLAN RN
Practice Location Address:

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68005-3907

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Practice Fax: 402-291-3906

1356659221 — JENNIFER GREEN LPN
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Directions to “TELECARE MENTAL HEALTH SERVICES OF NEBRASKA, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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