Provider Demographics
NPI:1609646587
Name:NUTILE, SHAUNTEL SHEREE (LMHP LMSW)
Entity Type:Individual
Prefix:
First Name:SHAUNTEL
Middle Name:SHEREE
Last Name:NUTILE
Suffix:
Gender:F
Credentials:LMHP LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 S 160TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1755
Mailing Address - Country:US
Mailing Address - Phone:402-800-7276
Mailing Address - Fax:
Practice Address - Street 1:2809 S 160TH ST STE 101
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1755
Practice Address - Country:US
Practice Address - Phone:402-800-7276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical