Basic Information
| Provider Information | |||||||||
| NPI: | 1942325022 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARENS | ||||||||
| FirstName: | KATHY | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | PMHP, PMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50696 WELLINGTON RD | ||||||||
| Address2: | |||||||||
| City: | EWING | ||||||||
| State: | NE | ||||||||
| PostalCode: | 687355358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026267992 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 KOENIGSTEIN AVE | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | NE | ||||||||
| PostalCode: | 687013664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026447533 | ||||||||
| FaxNumber: | 4026447510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6801 | NE | X | Behavioral Health & Social Service Providers | Counselor | Mental Health | 104100000X | 6268 | NE | X | Behavioral Health & Social Service Providers | Social Worker |
ID Information
| ID | Type | State | Issuer | Description | 47079687531 | 05 | NE | MEDICAID |