Provider Demographics
NPI:1659446482
Name:ATHERTON, JOHN RICHARD (MS LMHP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:RICHARD
Last Name:ATHERTON
Suffix:
Gender:M
Credentials:MS LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 W DODGE RD
Mailing Address - Street 2:422
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3322
Mailing Address - Country:US
Mailing Address - Phone:402-397-2147
Mailing Address - Fax:402-391-2633
Practice Address - Street 1:9140 W DODGE RD
Practice Address - Street 2:422
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3322
Practice Address - Country:US
Practice Address - Phone:402-397-2147
Practice Address - Fax:402-391-2633
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE197101YM0800X
NE3101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)