MEDICARE: BONNIE LAURIE BROWN LMHP

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	3241	NE

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

General Provider Information

NPI Number	:	1801952437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE LAURIE BROWN LMHP

Provider Business Mailing Address
First Line	:	3621 HOLMES PARK RD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-4643
Country	:	US
Telephone Number	:	308-379-3116
Fax Number	:	402-682-8807

Provider Business Practice Location Address
First Line	:	2130 S 17TH ST STE 100
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68502-3750
Country	:	US
Telephone Number	:	308-379-3116
Fax Number	:	402-682-8807

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	08/15/2016

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