Basic Information
| Provider Information | |||||||||
| NPI: | 1184616724 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VOGEL | ||||||||
| FirstName: | HARLAN | ||||||||
| MiddleName: | HERBERT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MHP CPC CCGC NCGC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10403 PINEHURST AVE | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681241879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023931127 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2101 S 42ND ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681052947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025527466 | ||||||||
| FaxNumber: | 4025527444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CPC 994 | NE | X | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | CCGC 002 | NE | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | LMHP 1627 | NE | X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.