Basic Information
Provider Information
NPI: 1174037121
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VRBKA
FirstName: ANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMHP, LADC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4545 S 86TH ST
Address2:  
City: LINCOLN
State: NE
PostalCode: 685269262
CountryCode: US
TelephoneNumber: 4024836990
FaxNumber: 4024836990
Practice Location
Address1: 4545 S 86TH ST
Address2:  
City: LINCOLN
State: NE
PostalCode: 685269262
CountryCode: US
TelephoneNumber: 4024836990
FaxNumber: 4024837045
Other Information
ProviderEnumerationDate: 11/29/2017
LastUpdateDate: 01/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X1070NEN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800X4407NEY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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