Provider Demographics
NPI:1376965640
Name:SCHMIDT SPEECH LANGUAGE PATHOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:SCHMIDT SPEECH LANGUAGE PATHOLOGY SERVICES LLC
Other - Org Name:THERAPY WORKS OF NEBRASKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:HINMAN
Authorized Official - Last Name:PRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-815-7527
Mailing Address - Street 1:3925 S 147TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5576
Mailing Address - Country:US
Mailing Address - Phone:402-942-1329
Mailing Address - Fax:402-606-4664
Practice Address - Street 1:3925 S 147TH ST STE 109
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5576
Practice Address - Country:US
Practice Address - Phone:402-942-1329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 235Z00000X
NE1361235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026342900Medicaid