Forensic Behavioral Health, Inc.
Organization Active NPI Clinical Psychologist · Papillion, NE
NPI 1366773095 · NPPES record last updated Jan 20, 2010
Key facts
- NPI
- 1366773095
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 567 (NE)
- Legal business name
- FORENSIC BEHAVIORAL HEALTH, INC.
- Practice address
- 1410 E Gold Coast Rd
Suite 800
Papillion, NE 68046-5799 - Phone
- (402) 557-6027
- Fax
- (402) 557-6028
- NPI assigned
- Jan 20, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Kirk Allen Brunswig Newring, PH.D.
- Title
- Owner
- Phone
- (402) 557-6027
Practitioners 3
-
Melissa D Brestel, LIMHP, LCSW
-
Kersten Rene' Borer, LIMHP, CMSW, LADC
-
James M Burger, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100520000989 | NE | Part B Supplier - Clinic/Group Practice | 0446389936 |
Receives reassigned benefits from 1 practitioner Practice locations: Papillion, NE |
National Provider Directory
Locations
1410 E Gold Coast Rd
Ste 800
Papillion, NE 68046
Phone (402) 557-6027
1410 E Gold Coast Rd
Ste 300
Papillion, NE 68046
Phone (402) 557-6027
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 1045 | NE | |
| Clinical Psychologist |
103TC0700X | 567 | NE | Yes |
| Clinical Psychologist |
103TC0700X | 506 | NE | |
| Clinical Psychologist |
103TC0700X | 149 | NE |
Addresses
Primary practice location
1410 E Gold Coast Rd
Suite 800
Papillion, NE 68046-5799
Mailing address
1410 E Gold Coast Rd
Suite 800
Papillion, NE 68046-5799
Phone (402) 557-5027
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025810100 | Medicaid | NE |
Other providers in Papillion, NE
- Martina J Foell
- Megan Foley
- Foot and Ankle Center of Nebraska, P.C.
- Foot and Ankle Center of Nebraska, P.C.
- Emily Rose Forbes
- Mary Forest
- Andrew F Forman
- Michelle Marie Foster
- Alicia Diane Fraley
- Francene D. Buda Dardon, Ms, PC
All providers in Papillion, NE · Clinical Psychologist 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 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.