| Collaborative Psych Practitioners | |
|
12077 Elmwood Dr Bennington NE 68007-1716 | |
| (402) 332-7648 | |
| Not Available |
| Full Name | Collaborative Psych Practitioners |
|---|---|
| Speciality | Clinic/Center |
| Location | 12077 Elmwood Dr, Bennington, Nebraska |
| Authorized Official Name and Position | Molly Petersen (CO-OWNER) |
| Authorized Official Contact | 4023327648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Psych Practitioners 12077 Elmwood Dr Bennington NE 68007-1716 Ph: (402) 332-7648 | Collaborative Psych Practitioners 12077 Elmwood Dr Bennington NE 68007-1716 Ph: (402) 332-7648 |
| NPI Number | 1922532324 |
|---|---|
| Provider Enumeration Date | 04/12/2017 |
| Last Update Date | 04/12/2017 |
| Medicare PECOS PAC ID | 2264701598 |
|---|---|
| Medicare Enrollment ID | O20170630000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922532324 | NPI | - | NPPES |
| Provider Name | Kimberly K Camp-grimit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659468213 PECOS PAC ID: 4082611470 Enrollment ID: I20061027000044 |
| Provider Name | Lyndsay Marie Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598803843 PECOS PAC ID: 1557464666 Enrollment ID: I20070309000525 |
| Provider Name | Molly A Petersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679987432 PECOS PAC ID: 9436378890 Enrollment ID: I20140917000192 |
| Provider Name | Rachel M Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144690132 PECOS PAC ID: 1658671797 Enrollment ID: I20151123000622 |
| Provider Name | Kristina M Faimon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023269909 PECOS PAC ID: 7113244559 Enrollment ID: I20190503000146 |
| Provider Name | Alexandra King Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851801997 PECOS PAC ID: 5395168785 Enrollment ID: I20200701002292 |
| Provider Name | Stephanie Herkenrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346963469 PECOS PAC ID: 9830565621 Enrollment ID: I20221019001850 |