Provider Demographics
NPI:1104830561
Name:ANSON, EMILY P (LMHP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:P
Last Name:ANSON
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:PFEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP
Mailing Address - Street 1:11319 P ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-6302
Mailing Address - Country:US
Mailing Address - Phone:308-379-4388
Mailing Address - Fax:
Practice Address - Street 1:11319 P ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-6302
Practice Address - Country:US
Practice Address - Phone:308-379-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1479101YM0800X
NE3214101YM0800X
CO4962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47-0785436-26Medicaid