Provider Demographics
NPI:1093480808
Name:BEISTER, STEPHANIE L (LIMHP, MSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:BEISTER
Suffix:
Gender:F
Credentials:LIMHP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 GOLDEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2837
Mailing Address - Country:US
Mailing Address - Phone:402-242-3483
Mailing Address - Fax:402-207-5574
Practice Address - Street 1:1941 S 42ND ST STE 510
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2945
Practice Address - Country:US
Practice Address - Phone:402-242-3483
Practice Address - Fax:402-207-5574
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20471041C0700X
NE2736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical