Midwest Neurofeedback, Llc | |
1530 S 70th St Ste 200 Lincoln NE 68506-1567 | |
(402) 327-0073 | |
Not Available |
Full Name | Midwest Neurofeedback, Llc |
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Speciality | Psychologist |
Location | 1530 S 70th St Ste 200, Lincoln, Nebraska |
Authorized Official Name and Position | George E Williams (PRESIDENT) |
Authorized Official Contact | 4024831936 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Midwest Neurofeedback, Llc 1530 S 70th St Ste 200 Lincoln NE 68506-1567 Ph: (402) 327-0073 | Midwest Neurofeedback, Llc 1530 S 70th St Ste 200 Lincoln NE 68506-1567 Ph: (402) 327-0073 |
NPI Number | 1760863260 |
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Provider Enumeration Date | 06/11/2015 |
Last Update Date | 06/11/2015 |
Medicare PECOS PAC ID | 7113260225 |
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Medicare Enrollment ID | O20190513001611 |
Identifier | Type | State | Issuer |
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1760863260 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | (Nebraska) | Primary |
Provider Name | Aaron C Stratman |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1568486801 PECOS PAC ID: 7719071687 Enrollment ID: I20070922000144 |
Provider Name | Kara J Antoniak |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588939706 PECOS PAC ID: 3173866514 Enrollment ID: I20190528001459 |
Provider Name | Tim R Riley |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1386721173 PECOS PAC ID: 2163755836 Enrollment ID: I20190612000437 |
Provider Name | Susan E Gripp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679156541 PECOS PAC ID: 4880090414 Enrollment ID: I20210908000825 |
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