Provider Demographics
NPI:1285011239
Name:AMBER JURGENSMEIER P.C.
Entity Type:Organization
Organization Name:AMBER JURGENSMEIER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:JURGENSMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LADC
Authorized Official - Phone:402-340-4909
Mailing Address - Street 1:16009 CURTIS AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116
Mailing Address - Country:US
Mailing Address - Phone:402-340-4909
Mailing Address - Fax:
Practice Address - Street 1:11713 M CIRCLE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137
Practice Address - Country:US
Practice Address - Phone:402-933-4411
Practice Address - Fax:888-507-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE946101YA0400X
NE13171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty