| Grand Island Mental Health Llc | |
|
1917 W Faidley Ave Grand Island NE 68803-4642 | |
| (308) 398-0350 | |
| (308) 398-0351 |
| Full Name | Grand Island Mental Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 1917 W Faidley Ave, Grand Island, Nebraska |
| Authorized Official Name and Position | Debra K Erickson (OWNER) |
| Authorized Official Contact | 3083980350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Island Mental Health Llc 1917 W Faidley Ave Grand Island NE 68803-4642 Ph: (308) 398-0350 | Grand Island Mental Health Llc 1917 W Faidley Ave Grand Island NE 68803-4642 Ph: (308) 398-0350 |
| NPI Number | 1306289194 |
|---|---|
| Provider Enumeration Date | 04/10/2013 |
| Last Update Date | 12/14/2020 |
| Certification Date | 12/14/2020 |
| Medicare PECOS PAC ID | 1153734629 |
|---|---|
| Medicare Enrollment ID | O20201231000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306289194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Janet R Jurgensen Duba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609966043 PECOS PAC ID: 8426016114 Enrollment ID: I20041228000713 |
| Provider Name | Kylene M Schroer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033317722 PECOS PAC ID: 3870686421 Enrollment ID: I20070912000618 |
| Provider Name | Celianne Bacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588265615 PECOS PAC ID: 4789096470 Enrollment ID: I20201222002498 |
| Provider Name | Cheryl Lockett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285922369 PECOS PAC ID: 1951695279 Enrollment ID: I20210106000808 |
| Provider Name | Anne Niffenegger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205541042 PECOS PAC ID: 7719350842 Enrollment ID: I20230310000322 |
| Provider Name | Jennifer L Chavez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417650250 PECOS PAC ID: 5092175448 Enrollment ID: I20230717001758 |
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