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NPI Code Detail

MEDICARE: NORTHEAST NEBRASKA PSYCHOLOGICAL SERVICES, PC

MEDICARE: NORTHEAST NEBRASKA PSYCHOLOGICAL SERVICES, PC
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
1251S00000XCommunity/Behavioral Health Agency733NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770806812
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEAST NEBRASKA PSYCHOLOGICAL SERVICES, PC
Provider Business Mailing Address
First Line : PO BOX 163
Second Line :
City : OAKLAND
State : NE
Zip : 68045-0163
Country : US
Telephone Number : 402-685-5116
Fax Number : 402-685-5817
Provider Business Practice Location Address
First Line : 211 N ENGDAHL AVE
Second Line :
City : OAKLAND
State : NE
Zip : 68045-1431
Country : US
Telephone Number : 402-685-5116
Fax Number : 402-685-5817
Authorized Official
Title or Position : PRESIDENT
Name : DR. LINDA A HUNTER
Credential : PSY.D.
Telephone Number : 402-870-1864
Provider Enumeration Date : 03/03/2010
Last Update Date : 03/03/2010

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Practice Location Address:
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