Provider Demographics
NPI:1881827541
Name:KONERT, NICOLE MICHELLE
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MICHELLE
Last Name:KONERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W PHILLIP AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5248
Mailing Address - Country:US
Mailing Address - Phone:402-371-8000
Mailing Address - Fax:402-371-0971
Practice Address - Street 1:302 W PHILLIP AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5248
Practice Address - Country:US
Practice Address - Phone:402-371-8000
Practice Address - Fax:402-371-0971
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12155101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor