Provider Demographics
NPI:1891074704
Name:OASIS COUNSELING INTERNATIONAL
Entity Type:Organization
Organization Name:OASIS COUNSELING INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:STORTVEDT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:4023-792-0301
Mailing Address - Street 1:333 W NORFOLK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5221
Mailing Address - Country:US
Mailing Address - Phone:402-379-2030
Mailing Address - Fax:402-379-3933
Practice Address - Street 1:221 W DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1715
Practice Address - Country:US
Practice Address - Phone:402-336-3009
Practice Address - Fax:402-336-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YA0400X, 101YM0800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE96104OtherBLUE CROSS/BLUE SHIELD
NE=========Medicaid