Provider Demographics
NPI:1568649432
Name:ROUSE, JENINE MARIE (LMHP)
Entity Type:Individual
Prefix:MRS
First Name:JENINE
Middle Name:MARIE
Last Name:ROUSE
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:MISS
Other - First Name:JENINE
Other - Middle Name:MARIE
Other - Last Name:URBOM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHP
Mailing Address - Street 1:8650 PIONEERS BLVD
Mailing Address - Street 2:SAMARITAN COUNSELING CENTER
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68520
Mailing Address - Country:US
Mailing Address - Phone:402-483-5117
Mailing Address - Fax:402-483-5154
Practice Address - Street 1:8650 PIONEERS BLVD
Practice Address - Street 2:SAMARITAN COUNSELING CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68520
Practice Address - Country:US
Practice Address - Phone:402-483-5117
Practice Address - Fax:402-483-5154
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health