| |
1941 S 42nd St Ste 328 Omaha NE 68105-2943 | |
(402) 614-8444 | |
Not Available |
Full Name | |
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Speciality | Psychologist |
Location | 1941 S 42nd St Ste 328, Omaha, Nebraska |
Authorized Official Name and Position | Kerry Biscornet (SECRETARY) |
Authorized Official Contact | 6088542929 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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11000 Optum Cir Eden Prairie MN 55344-2503 Ph: (608) 854-2929 | 1941 S 42nd St Ste 328 Omaha NE 68105-2943 Ph: (402) 614-8444 |
NPI Number | 1033985726 |
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Provider Enumeration Date | 12/04/2023 |
Last Update Date | 09/20/2024 |
Certification Date | 09/20/2024 |
Medicare PECOS PAC ID | 7719325083 |
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Medicare Enrollment ID | O20241018003176 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033985726 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
Provider Name | Jennifer L Lindner |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1922203793 PECOS PAC ID: 1850487554 Enrollment ID: I20071010000755 |
Provider Name | Samantha Marie Baumert |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1033712922 PECOS PAC ID: 5395182851 Enrollment ID: I20240320002555 |
Provider Name | Dana Ritterbush |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1144362641 PECOS PAC ID: 4486189941 Enrollment ID: I20241121001675 |
Provider Name | Aaron Titus |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1245982271 PECOS PAC ID: 7113452426 Enrollment ID: I20241122004152 |
Provider Name | Carolyn Louise Chambers |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1003483884 PECOS PAC ID: 3870028608 Enrollment ID: I20241203000931 |
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