| Katherine Nicolarsen, Llc | |
|
11840 Nicholas St Ste 205 Omaha NE 68154-4475 | |
| (402) 215-9220 | |
| Not Available |
| Full Name | Katherine Nicolarsen, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11840 Nicholas St Ste 205, Omaha, Nebraska |
| Authorized Official Name and Position | Katherine Nicolarsen (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4022159220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Nicolarsen, Llc 11840 Nicholas St Ste 205 Omaha NE 68154-4475 Ph: (402) 215-9220 | Katherine Nicolarsen, Llc 11840 Nicholas St Ste 205 Omaha NE 68154-4475 Ph: (402) 215-9220 |
| NPI Number | 1093541203 |
|---|---|
| Provider Enumeration Date | 09/12/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 2668908500 |
|---|---|
| Medicare Enrollment ID | O20241216001012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093541203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katherine A Nicolarsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508858648 PECOS PAC ID: 8022184720 Enrollment ID: I20080903000544 |
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