Provider Demographics
NPI:1891442273
Name:GROEBLI, SKYLER SUE (PLMHP, PLADC)
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:SUE
Last Name:GROEBLI
Suffix:
Gender:F
Credentials:PLMHP, PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2661
Mailing Address - Country:US
Mailing Address - Phone:402-366-4754
Mailing Address - Fax:
Practice Address - Street 1:230 E 22ND ST STE 4
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2661
Practice Address - Country:US
Practice Address - Phone:402-366-4754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12930101YM0800X
NE6067101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)