Provider Demographics
NPI:1215824313
Name:NEVIS, LEON ADEBO
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:ADEBO
Last Name:NEVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9012 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3549
Mailing Address - Country:US
Mailing Address - Phone:309-203-2567
Mailing Address - Fax:
Practice Address - Street 1:9012 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3549
Practice Address - Country:US
Practice Address - Phone:309-203-2567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral