Provider Demographics
NPI:1568590412
Name:STESSMAN, GARY JOSEPH (MS, PLMHP)
Entity Type:Individual
Prefix:PROF
First Name:GARY
Middle Name:JOSEPH
Last Name:STESSMAN
Suffix:
Gender:M
Credentials:MS, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1102
Mailing Address - Country:US
Mailing Address - Phone:402-944-6038
Mailing Address - Fax:
Practice Address - Street 1:3223 N 169TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2650
Practice Address - Country:US
Practice Address - Phone:402-813-2235
Practice Address - Fax:402-502-1282
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1013003623OtherGROUP NPI NUMBER