MEDICARE: JENNIFER SUKUP LIMHP, LADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	926	NE
2	101YM0800X	Mental Health Counselor	2734	NE
3	101YM0800X	Mental Health Counselor	797	NE

General Provider Information

NPI Number	:	1952441735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SUKUP LIMHP, LADC

Provider Business Mailing Address
First Line	:	516 N DEWEY ST STE 1
Second Line	:
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101-3928
Country	:	US
Telephone Number	:	308-660-3257
Fax Number	:	800-616-0783

Provider Business Practice Location Address
First Line	:	516 N DEWEY ST STE 1
Second Line	:
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101-3928
Country	:	US
Telephone Number	:	308-660-3257
Fax Number	:	800-616-0783

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	02/22/2023

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