Provider Demographics
NPI:1265761068
Name:HAASE, KATHERINE A (LADC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:A
Last Name:HAASE
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1124
Mailing Address - Country:US
Mailing Address - Phone:402-441-7940
Mailing Address - Fax:
Practice Address - Street 1:3300 N 60TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3402
Practice Address - Country:US
Practice Address - Phone:402-829-9258
Practice Address - Fax:402-551-8797
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
NE708101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker