| Immaculate Heart Of Mary Counseling Center | |
|
3700 Sheridan Blvd Ste 1 Lincoln NE 68506-6100 | |
| (402) 489-1834 | |
| (402) 489-2046 |
| Full Name | Immaculate Heart Of Mary Counseling Center |
|---|---|
| Speciality | Counselor |
| Location | 3700 Sheridan Blvd, Lincoln, Nebraska |
| Authorized Official Name and Position | Courtney K Miller (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 4024891834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Immaculate Heart Of Mary Counseling Center 8055 O St Ste 301 Lincoln NE 68510-2564 Ph: (402) 489-1834 | Immaculate Heart Of Mary Counseling Center 3700 Sheridan Blvd Ste 1 Lincoln NE 68506-6100 Ph: (402) 489-1834 |
| NPI Number | 1982618328 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 7214023993 |
|---|---|
| Medicare Enrollment ID | O20071010000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982618328 | NPI | - | NPPES |
| 10026870000 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Courtney K Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699789768 PECOS PAC ID: 6608942875 Enrollment ID: I20080912000114 |
| Provider Name | Peter E Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568653020 PECOS PAC ID: 0941498844 Enrollment ID: I20101220000327 |
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