Provider Demographics
NPI:1699389908
Name:BLANCO, EMILIANA ISABELLA (LIMHP)
Entity Type:Individual
Prefix:MS
First Name:EMILIANA
Middle Name:ISABELLA
Last Name:BLANCO
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S 42ND ST STE 541
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2986
Mailing Address - Country:US
Mailing Address - Phone:402-934-4618
Mailing Address - Fax:402-934-4628
Practice Address - Street 1:6631 EMMET ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3208
Practice Address - Country:US
Practice Address - Phone:402-235-5832
Practice Address - Fax:402-934-4628
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7524104100000X
NE12357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker