MEDICARE: MS. TERRY ELLEN STEWART-DESECK LIMHP, LCSW

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	777	NE
2	104100000X	Social Worker	1377	NE
3	1041C0700X	Clinical Social Worker	1377	NE

General Provider Information

NPI Number	:	1851350904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERRY ELLEN STEWART-DESECK LIMHP, LCSW

Provider Business Mailing Address
First Line	:	7516 S 30TH ST
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68147-1312
Country	:	US
Telephone Number	:	785-233-7962
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 GALVIN RD N
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68005-4852
Country	:	US
Telephone Number	:	402-779-1316
Fax Number	:

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

Provider Enumeration Date	:	03/18/2006
Last Update Date	:	05/28/2019

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