Provider Demographics
NPI:1225418551
Name:FLORES, JENNIFER (LMHP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1561
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-1561
Mailing Address - Country:US
Mailing Address - Phone:402-332-8318
Mailing Address - Fax:
Practice Address - Street 1:7905 L ST STE 410
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1732
Practice Address - Country:US
Practice Address - Phone:402-332-8318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026811900Medicaid