Provider Demographics
NPI:1508678939
Name:KLOPPENBORG, JUSTIN P
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:P
Last Name:KLOPPENBORG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10416 FORT PLZ APT 7
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1227
Mailing Address - Country:US
Mailing Address - Phone:402-340-8573
Mailing Address - Fax:
Practice Address - Street 1:1219 S 166TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1320
Practice Address - Country:US
Practice Address - Phone:402-340-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker