Provider Demographics
NPI:1629154034
Name:LOOP, BERTINE KATHRYN (LIMHP CSW BCD)
Entity Type:Individual
Prefix:MS
First Name:BERTINE
Middle Name:KATHRYN
Last Name:LOOP
Suffix:
Gender:F
Credentials:LIMHP CSW BCD
Other - Prefix:
Other - First Name:BERTINE
Other - Middle Name:KATHRYN
Other - Last Name:LOOP-SCHENKEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIMHP CSW BCD
Mailing Address - Street 1:300 S 68TH STREET PL
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2475
Mailing Address - Country:US
Mailing Address - Phone:402-434-2730
Mailing Address - Fax:402-434-3970
Practice Address - Street 1:300 S 68TH STREET PL
Practice Address - Street 2:SUITE 500
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2475
Practice Address - Country:US
Practice Address - Phone:402-434-2730
Practice Address - Fax:402-434-3970
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE331101YM0800X
NE246104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47075636930Medicaid
NE47075636930Medicaid
MT053298OtherVALUE OPTIONS
NELMHP976CMSW246OtherLICENSE AND CERTIFICATE
MT349849000OtherMAGELLAN
NE349849000OtherUNITED HEALTH CARE-UBH