Provider Demographics
NPI:1881112506
Name:EBERLE, CHANTEL (LIMHP)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:EBERLE
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 S 150TH PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5538
Mailing Address - Country:US
Mailing Address - Phone:402-215-9998
Mailing Address - Fax:402-991-7631
Practice Address - Street 1:1309 HARLAN DR STE 102
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-6604
Practice Address - Country:US
Practice Address - Phone:402-215-9998
Practice Address - Fax:402-991-7631
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5063101Y00000X
NE2001101YP2500X
NE10724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional