Justin Lee Hannemann, LIMHP

Individual provider Active NPI Marriage & Family Therapist · Lincoln, NE

NPI 1003155482 · NPPES record last updated Oct 26, 2023

Key facts

NPI
1003155482
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1028 (NE)
Practice address
1510 Q St
Lincoln, NE 68508-1647
Phone
(402) 913-4999
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1028NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gracepoint Institute for Relational Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1028 NE Yes

Addresses

Primary practice location

1510 Q St
Lincoln, NE 68508-1647

Mailing address

54 Lincoln St
Seward, NE 68434-1559
Phone (402) 913-4999

Other providers in Lincoln, NE

All providers in Lincoln, NE · Marriage & Family Therapist in Nebraska

Sources for this page

Verify at the official NPI Registry.