Provider Demographics
NPI:1073717708
Name:WEMHOFF, NICOLE (MA, LMHP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:WEMHOFF
Suffix:
Gender:F
Credentials:MA, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12510 S 217TH ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-5996
Mailing Address - Country:US
Mailing Address - Phone:402-871-7964
Mailing Address - Fax:
Practice Address - Street 1:9040 TURNBERRY CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9233
Practice Address - Country:US
Practice Address - Phone:402-871-7964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3266101YM0800X
IA00936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health