Anderson, Jacqueline Anne

Anderson, Jacqueline Anne is an sole proprietor health care provider with primary practice located at 408 10Th St , Gothenburg NE 69138-1922. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Anderson, Jacqueline Anne can be contacted via phone (308) 529-0821.

Contact Information

Primary practice address
408 10Th St Gothenburg NE 69138-1922
Phone: (308) 529-0821
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2756 Nebraska
Behavioral Health & Social Service Providers / Professional 101YP2500X 1465 Nebraska
Behavioral Health & Social Service Providers / School 103TS0200X 31858 Nebraska

Profile Details

NPI number 1346397338
LBN Legal business name Anderson, Jacqueline Anne
Credentials ED.S, LMHP, LPC,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346397338 NPPES
Nebraska MEDICAID 10025003500

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