Provider Demographics
NPI:1811709033
Name:TESTER, THERESA ANN (MS, LPC, LMHP)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANN
Last Name:TESTER
Suffix:
Gender:F
Credentials:MS, LPC, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8557 S 64TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68157-2191
Mailing Address - Country:US
Mailing Address - Phone:402-659-2174
Mailing Address - Fax:
Practice Address - Street 1:8557 S 64TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68157-2191
Practice Address - Country:US
Practice Address - Phone:402-659-2174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X, 372600000X
NE1037101YM0800X
NE722101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No372600000XNursing Service Related ProvidersAdult Companion