| Brooke Gundrum Storm Ms Plmhp | |
|
10730 Pacific St Ste 30 Omaha NE 68114-4761 | |
| (402) 637-8024 | |
| Not Available |
| Full Name | Brooke Gundrum Storm Ms Plmhp |
|---|---|
| Speciality | Counselor |
| Location | 10730 Pacific St Ste 30, Omaha, Nebraska |
| Authorized Official Name and Position | Brooke Gundrum Storm (OWNER) |
| Authorized Official Contact | 5312429489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooke Gundrum Storm Ms Plmhp 10866 Newport Ave Omaha NE 68164-1242 Ph: (531) 242-9489 | Brooke Gundrum Storm Ms Plmhp 10730 Pacific St Ste 30 Omaha NE 68114-4761 Ph: (402) 637-8024 |
| NPI Number | 1902371727 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 10/02/2023 |
| Certification Date | 10/02/2023 |
| Medicare PECOS PAC ID | 7810336476 |
|---|---|
| Medicare Enrollment ID | O20240415003844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902371727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brooke Storm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629513122 PECOS PAC ID: 8729427380 Enrollment ID: I20240415003868 |
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