Provider Demographics
NPI:1811304843
Name:GARTIN, NATASHA MARIE (LMHP, LPC, PLADC)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIE
Last Name:GARTIN
Suffix:
Gender:F
Credentials:LMHP, LPC, PLADC
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:MARIE
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLMHP
Mailing Address - Street 1:3801 UNION DR STE 206
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6652
Mailing Address - Country:US
Mailing Address - Phone:402-489-2218
Mailing Address - Fax:
Practice Address - Street 1:3801 UNION DR STE 206
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6652
Practice Address - Country:US
Practice Address - Phone:402-489-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10272101Y00000X
NE4746101YM0800X
NE2285101Y00000X
NEP-1345101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2285OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES
NE10272OtherNEBRASKA LICENSE
NE4756OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES
NEP-1345OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES