Provider Demographics
NPI:1184870081
Name:OZ, YESHIM (MS, MA,)
Entity type:Individual
Prefix:MRS
First Name:YESHIM
Middle Name:
Last Name:OZ
Suffix:
Gender:F
Credentials:MS, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11909 ARBOR ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4400
Mailing Address - Country:US
Mailing Address - Phone:402-933-6101
Mailing Address - Fax:
Practice Address - Street 1:11414 W CENTER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4486
Practice Address - Country:US
Practice Address - Phone:402-330-4014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3669101YM0800X
NE1087101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068631113Medicaid