Provider Demographics
NPI:1376026245
Name:BJORNSEN, ABBY JO (PMHP)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:JO
Last Name:BJORNSEN
Suffix:
Gender:F
Credentials:PMHP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:JO
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4868 S 186TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-3532
Mailing Address - Country:US
Mailing Address - Phone:308-380-7584
Mailing Address - Fax:
Practice Address - Street 1:5300 GEORGE B LAKE PKWY
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-6483
Practice Address - Country:US
Practice Address - Phone:402-715-8478
Practice Address - Fax:402-715-6196
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE97911041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool