Provider Demographics
NPI:1851552749
Name:TRUE, PATRICIA ANN
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:TRUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:GUBBLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP, LADC, LIMHP
Mailing Address - Street 1:333 W NORFOLK AVE
Mailing Address - Street 2:STE. 201
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5232
Mailing Address - Country:US
Mailing Address - Phone:402-379-2030
Mailing Address - Fax:402-379-1249
Practice Address - Street 1:333 W NORFOLK AVE
Practice Address - Street 2:STE. 201
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5232
Practice Address - Country:US
Practice Address - Phone:402-379-2030
Practice Address - Fax:402-379-1249
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2342101YM0800X
NE504101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE391894354Medicaid