MRS. BRENDA L TICKNOR LIMHP LMHC SADC L NPI 1093982118

NPI Information

NPI: 1093982118
Provider Name: MRS. BRENDA L TICKNOR, LIMHP, LMHC, SADC, L
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Individual
PECOS Registration: Yes
Address: 427 E. KANESVILLE BLVD.
SUITE 308
COUNCIL BLUFFS, IA
ZIP 51503
Phone: (402) 616-9876

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NPI Details

MRS. Brenda L Ticknor, LIMHP, LMHC, SADC, L is a mental health counselor in Council Bluffs, IA with 15 years of experience. MRS. Brenda L Ticknor, LIMHP, LMHC, SADC, L NPI is 1093982118. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

427 E. KANESVILLE BLVD.
SUITE 308
COUNCIL BLUFFS, IA
ZIP 51503-499
Phone: (402) 616-9876
Fax: (712) 355-5120

The NPI 1093982118 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/8/2008 and was last updated on 9/6/2019.

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	4316	NEBRASKA	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	814	NEBRASKA	No
3	101YM0800X	Counselor	Mental Health	9295	NEBRASKA	No
4	101YM0800X	Counselor	Mental Health	1543	NEBRASKA	Yes
5	101Y00000X	Counselor		2098	NEBRASKA	No

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	814	OTHER	NEBRASKA	LADC
2	9295	OTHER	NEBRASKA	PLMHP

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: 3/30/2025

NPI Synchronization or Removal

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