Provider Demographics
NPI:1083090922
Name:TATRO, JOSEPH C (MS, PLMHP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:C
Last Name:TATRO
Suffix:
Gender:M
Credentials:MS, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 SHERIDAN BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-6100
Mailing Address - Country:US
Mailing Address - Phone:402-489-1834
Mailing Address - Fax:
Practice Address - Street 1:3700 SHERIDAN BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6100
Practice Address - Country:US
Practice Address - Phone:402-489-1834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health