Provider Demographics
NPI:1083243158
Name:HERRICK, STEPHANIE (PLMHP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HERRICK
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2920
Mailing Address - Country:US
Mailing Address - Phone:402-441-7949
Mailing Address - Fax:
Practice Address - Street 1:501 S 7TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2920
Practice Address - Country:US
Practice Address - Phone:402-441-7949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health