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NPI Code Detail

MEDICARE: JENNIFER L ANTHOLZ

MEDICARE: JENNIFER L ANTHOLZ
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
1101YM0800XMental Health Counselor9760NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113231OTHERNEPROVISIONAL MENTAL HEALTH PRACTITIONER

General Provider Information

NPI Number : 1780935569
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L ANTHOLZ
Provider Business Mailing Address
First Line : PO BOX 406
Second Line :
City : SAINT PAUL
State : NE
Zip : 68873-0406
Country : US
Telephone Number : 308-754-4421
Fax Number : 308-754-2303
Provider Business Practice Location Address
First Line : 1113 SHERMAN ST
Second Line :
City : SAINT PAUL
State : NE
Zip : 68873-1546
Country : US
Telephone Number : 308-754-4421
Fax Number : 308-754-2303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2012
Last Update Date : 03/28/2025

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Directions to “ JENNIFER L ANTHOLZ ” Practice Location

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