Provider Demographics
NPI:1578634853
Name:OESTREICH, MARLYS JOAN (MS,LMHP,LADC,CSAT)
Entity Type:Individual
Prefix:
First Name:MARLYS
Middle Name:JOAN
Last Name:OESTREICH
Suffix:
Gender:F
Credentials:MS,LMHP,LADC,CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2970
Mailing Address - Country:US
Mailing Address - Phone:402-334-3044
Mailing Address - Fax:402-334-1693
Practice Address - Street 1:11911 ARBOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2970
Practice Address - Country:US
Practice Address - Phone:402-334-3044
Practice Address - Fax:402-334-1693
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2101YA0400X
NE356101YM0800X
NE100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
30001OtherMIDLANDS CHOICE
022799OtherVALUE OPTIONS
NE84241OtherBCBS