Provider Demographics
NPI:1467681353
Name:BURNS, HOLLY M (LIMHP)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:M
Last Name:BURNS
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5561 SOUTH 48TH STREET
Mailing Address - Street 2:STE. 215-D
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516
Mailing Address - Country:US
Mailing Address - Phone:402-540-0302
Mailing Address - Fax:402-581-6171
Practice Address - Street 1:5561 SOUTH 48TH STREET
Practice Address - Street 2:STE. 215-D
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-540-0302
Practice Address - Fax:402-581-6171
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8906101YM0800X
NE1205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1002685900Medicaid