Provider Demographics
NPI:1558879809
Name:BRUMMELS, LINDA (MS)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:BRUMMELS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LIN
Other - Middle Name:MARSHALL
Other - Last Name:BRUMMELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:85365 567TH AVE
Mailing Address - Street 2:
Mailing Address - City:WINSIDE
Mailing Address - State:NE
Mailing Address - Zip Code:68790
Mailing Address - Country:US
Mailing Address - Phone:402-833-8440
Mailing Address - Fax:
Practice Address - Street 1:421 N PEARL ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1904
Practice Address - Country:US
Practice Address - Phone:402-286-4891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1078101Y00000X, 101YM0800X
NE817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional