Provider Demographics
NPI:1417542630
Name:DEFY THE CYCLE LLC
Entity Type:Organization
Organization Name:DEFY THE CYCLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEISLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:402-853-6686
Mailing Address - Street 1:4535 NORMAL BLVD STE 295
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2890
Mailing Address - Country:US
Mailing Address - Phone:402-853-6686
Mailing Address - Fax:888-972-3644
Practice Address - Street 1:4535 NORMAL BLVD STE 295
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2890
Practice Address - Country:US
Practice Address - Phone:402-853-6686
Practice Address - Fax:888-972-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013996966OtherNPI