Basic Information
| Provider Information | |||||||||
| NPI: | 1346974458 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEL-TORO | ||||||||
| FirstName: | CHELSEA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PLMHP, CPHT, PSS | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DEL-TORO | ||||||||
| OtherFirstName: | CIEL | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PLMHP, CPHT, PSS | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1508 FORT ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681101354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3478681969 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1941 S 42ND ST STE 328 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681052943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026148444 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2022 | ||||||||
| LastUpdateDate: | 07/13/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 10666 | NE | N | Pharmacy Service Providers | Pharmacy Technician | 221700000X | 13028 | NE | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist | 101YP2500X | 13028 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | 13028 | NE | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 175T00000X | N | 101Y00000X | 13028 | NE | N | Behavioral Health & Social Service Providers | Counselor | 101200000X | 13028 | N |
No ID Information.