Provider Demographics
NPI:1003314287
Name:BIVENS, KRISTEN (LMHP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:BIVENS
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18422 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-3841
Mailing Address - Country:US
Mailing Address - Phone:402-350-8382
Mailing Address - Fax:
Practice Address - Street 1:3534 S 108TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4910
Practice Address - Country:US
Practice Address - Phone:402-408-8725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2048101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health