Provider Demographics
NPI:1417109190
Name:BAUER, DANIELLE (LIMHP, MFT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:LIMHP, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 HOLDREGE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3137
Mailing Address - Country:US
Mailing Address - Phone:402-486-3110
Mailing Address - Fax:
Practice Address - Street 1:3201 PIONEERS BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-5963
Practice Address - Country:US
Practice Address - Phone:402-486-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1245101YM0800X
NE146106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist