Provider Demographics
NPI:1417932393
Name:BROEKEMEIER, CHRISTINA (LIMHP,LMHP,MA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:BROEKEMEIER
Suffix:
Gender:F
Credentials:LIMHP,LMHP,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 FORT CROOK RD S STE 401
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2980
Mailing Address - Country:US
Mailing Address - Phone:402-350-1968
Mailing Address - Fax:402-292-0144
Practice Address - Street 1:1406 FORT CROOK RD S STE 401
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2980
Practice Address - Country:US
Practice Address - Phone:402-350-1968
Practice Address - Fax:402-292-0144
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7624101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100251588-00Medicaid
NE774453000OtherMAGELLAN MIS NUMBER