Provider Demographics
NPI:1518023506
Name:SEWELL, KATIE E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:E
Last Name:SEWELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:E
Other - Last Name:ERICSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8200 DODGE ST
Mailing Address - Street 2:CHILDREN'S HOSPITAL & MEDICAL CENTER
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4113
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:CHILDREN'S HOSPITAL & MEDICAL CTR - BEHAVIORAL HEALTH
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-3900
Practice Address - Fax:402-955-3920
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE612103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
244146OtherMIDLANDS CHOICE
NE4296OtherBCBS