Luke Donald Andersen, PLADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Omaha, NE

NPI 1053072033 · NPPES record last updated Feb 1, 2024

Key facts

NPI
1053072033
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
P-2139 (NE)
Practice address
5115 F St
Omaha, NE 68117-2807
Phone
(402) 397-9866
Fax
(402) 397-1404
NPI assigned
Jan 3, 2022
Sex
Male
Sole proprietor
No

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
P-2139NEMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X P-2139 NE Yes

Addresses

Primary practice location

5115 F St
Omaha, NE 68117-2807

Mailing address

5115 F St
Omaha, NE 68117-2807
Phone (402) 397-9866

Other providers in Omaha, NE

All providers in Omaha, NE · Addiction (Substance Use Disorder) Counselor in Nebraska

Sources for this page

Verify at the official NPI Registry.