| Integrative Psychiatry, Llc | |
|
20324 Veterans Dr Ste 104 Elkhorn NE 68022-3552 | |
| (402) 933-5700 | |
| (402) 933-9998 |
| Full Name | Integrative Psychiatry, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 20324 Veterans Dr Ste 104, Elkhorn, Nebraska |
| Authorized Official Name and Position | Macy Kasperbauer (CEO) |
| Authorized Official Contact | 4029335700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Psychiatry, Llc 20324 Veterans Dr Ste 104 Elkhorn NE 68022-3552 Ph: (402) 933-5700 | Integrative Psychiatry, Llc 20324 Veterans Dr Ste 104 Elkhorn NE 68022-3552 Ph: (402) 933-5700 |
| NPI Number | 1063051472 |
|---|---|
| Provider Enumeration Date | 01/02/2020 |
| Last Update Date | 04/07/2020 |
| Certification Date | 04/07/2020 |
| Medicare PECOS PAC ID | 8325478126 |
|---|---|
| Medicare Enrollment ID | O20200419000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063051472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Macy Lee Kasperbauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821465881 PECOS PAC ID: 1557677515 Enrollment ID: I20150904002196 |
| Provider Name | Noelle C Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972673119 PECOS PAC ID: 5991893398 Enrollment ID: I20190821003241 |
| Provider Name | Amanda S Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659960052 PECOS PAC ID: 7214342294 Enrollment ID: I20210225001258 |
| Provider Name | Kristi L Meints |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790261337 PECOS PAC ID: 3173994837 Enrollment ID: I20230118000148 |
| Provider Name | Arick Lars Grinberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942662606 PECOS PAC ID: 4486199569 Enrollment ID: I20240712002327 |
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