Provider Demographics
NPI:1174824866
Name:BABUTZKE, JAMIE LEE (MS)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:BABUTZKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5104
Mailing Address - Country:US
Mailing Address - Phone:402-463-5684
Mailing Address - Fax:402-463-5686
Practice Address - Street 1:616 W 5TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5104
Practice Address - Country:US
Practice Address - Phone:402-463-5684
Practice Address - Fax:402-463-5686
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9271-PLMHP101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health