SOUTHERN SUDAN COMM ASS NPI 1861518763

NPI Information

NPI: 1861518763
Provider Name: SOUTHERN SUDAN COMM ASS
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
3610 DODGE STREET
SUITE 100
OMAHA, NE
ZIP 68131
Phone: (402) 554-0759
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SOUTHERN SUDAN COMM ASS is a mental health counselor in Omaha, NE. SOUTHERN SUDAN COMM ASS NPI is 1861518763. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3610 DODGE STREET
SUITE 100
OMAHA, NE
ZIP 68131
Phone: (402) 554-0759
Fax: (402) 561-9724

The provider's authorized official is Julia H Allen .
The authorized official title is Supervising Lmhp and has the following contact phone number (402) 554-0759.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10025485800	MEDICAID	NEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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