Provider Demographics
NPI:1184807224
Name:HABERLAN, JOANNE E (MA)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:E
Last Name:HABERLAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 E HIGHWAY 33
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-2551
Mailing Address - Country:US
Mailing Address - Phone:402-826-5858
Mailing Address - Fax:402-826-5859
Practice Address - Street 1:995 E HIGHWAY 33
Practice Address - Street 2:SUITE 1
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-2551
Practice Address - Country:US
Practice Address - Phone:402-826-5858
Practice Address - Fax:402-826-5859
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47-077425426Medicaid