Brenda Hiebner, LIMHP

Individual provider Active NPI Mental Health Counselor · Gothenburg, NE

NPI 1225177652 · NPPES record last updated Jan 30, 2020

Key facts

NPI
1225177652
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
582 (NE)
Practice address
815 Lake Ave
Gothenburg, NE 69138
Phone
(308) 537-3691
Fax
(308) 537-3062
NPI assigned
Feb 5, 2007
Sex
Female
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
2162NEMDMental Health Counselor
582NEMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 582 NE Yes
Mental Health Counselor 101YM0800X 2162 NE

Addresses

Primary practice location

815 Lake Ave
Gothenburg, NE 69138

Mailing address

1512 Avenue G
Gothenburg, NE 69138-1716
Phone (308) 537-4306

Other identifiers

IdentifierTypeStateIssuer
10026398600MedicaidNE

Other providers in Gothenburg, NE

All providers in Gothenburg, NE · Mental Health Counselor in Nebraska

Sources for this page

Verify at the official NPI Registry.