| Attachment And Trauma Center Of Nebraska, Llc | |
|
638 N 109th Plz Omaha NE 68154-1722 | |
| (402) 403-0190 | |
| (402) 932-4121 |
| Full Name | Attachment And Trauma Center Of Nebraska, Llc |
|---|---|
| Speciality | Counselor |
| Location | 638 N 109th Plz, Omaha, Nebraska |
| Authorized Official Name and Position | Ann E Potter (PARTNER/TREASURER) |
| Authorized Official Contact | 4024030190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Attachment And Trauma Center Of Nebraska, Llc 638 N 109th Plz Omaha NE 68154-1722 Ph: (402) 403-0190 | Attachment And Trauma Center Of Nebraska, Llc 638 N 109th Plz Omaha NE 68154-1722 Ph: (402) 403-0190 |
| NPI Number | 1881866929 |
|---|---|
| Provider Enumeration Date | 03/28/2008 |
| Last Update Date | 09/05/2023 |
| Certification Date | 09/05/2023 |
| Medicare PECOS PAC ID | 5092879148 |
|---|---|
| Medicare Enrollment ID | O20090204000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881866929 | NPI | - | NPPES |
| Provider Name | Ann E Potter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063491413 PECOS PAC ID: 4284536749 Enrollment ID: I20040123001014 |
| Provider Name | Hope Denise Peabody |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174672539 PECOS PAC ID: 4688618713 Enrollment ID: I20050620000175 |
| Provider Name | Bonnie Jean Sarton Mierau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215154877 PECOS PAC ID: 6901129618 Enrollment ID: I20151023001822 |
| Provider Name | Teresa M Lenzen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033101183 PECOS PAC ID: 6709109408 Enrollment ID: I20240530004052 |
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