Provider Demographics
NPI:1265007397
Name:ERDMAN, JAMIE K (LIMHP, LADC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:K
Last Name:ERDMAN
Suffix:
Gender:F
Credentials:LIMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 2ND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3224
Mailing Address - Country:US
Mailing Address - Phone:308-633-2049
Mailing Address - Fax:308-633-9505
Practice Address - Street 1:1502 2ND AVE SUITE 2
Practice Address - Street 2:
Practice Address - City:SCOTTBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3224
Practice Address - Country:US
Practice Address - Phone:308-633-2049
Practice Address - Fax:308-633-9505
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1532101YA0400X
NE3193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty