Provider Demographics
NPI:1144753724
Name:VAN KALSBEEK, AMANDA (LIMHP, LMHC, IADC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:VAN KALSBEEK
Suffix:
Gender:F
Credentials:LIMHP, LMHC, IADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 MARCY ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2108
Mailing Address - Country:US
Mailing Address - Phone:605-212-7667
Mailing Address - Fax:
Practice Address - Street 1:11414 W CENTER RD STE 247
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4425
Practice Address - Country:US
Practice Address - Phone:402-881-0406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17134101YA0400X
IA085417101YM0800X
NE2482101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1316009475OtherGROUP NPI FOR HEARTLAND FAMILY SERVICE GENDLER
NE1639562069OtherGROUP NPI FOR HEARTLAND FAMILY SERVICE CENTERAL