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
| License | State | Type | Specialty |
|---|---|---|---|
| 2162 | NE | MD | Mental Health Counselor |
| 582 | NE | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10026398600 | Medicaid | NE |
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All providers in Gothenburg, NE · Mental Health Counselor in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.