Provider Demographics
NPI:1760926836
Name:LEMBKE, BRENDA (PLADC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:LEMBKE
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 N PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-6342
Mailing Address - Country:US
Mailing Address - Phone:402-753-7556
Mailing Address - Fax:
Practice Address - Street 1:2170 N PLATTE AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-6342
Practice Address - Country:US
Practice Address - Phone:402-753-7556
Practice Address - Fax:402-753-6445
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1430101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)