Whitcomb, Gordy J
Whitcomb, Gordy J is an sole proprietor health care provider with primary practice located at 1835 E Military Ave Suite 111, Fremont NE 68025-5477. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Whitcomb, Gordy J can be contacted via phone (402) 721-0245.Contact Information
Primary practice address
1835 E Military Ave Suite 111
Fremont NE 68025-5477
Phone: (402) 721-0245
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 137 | Nebraska |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 436 | Nebraska |
Profile Details
| NPI number | 1598891624 |
|---|---|
| LBN Legal business name | Whitcomb, Gordy J |
| Credentials | LMHP LADAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 25th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598891624 | NPPES |
| Nebraska | MEDICAID | 10025123300 | |
| Nebraska | Other | 84711 | |
| Nebraska | Other | 23036 | |
| Nebraska | Other | 93586 |
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