Individual
VICTORIA LYNNE CASSIDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMHP
Contact information
Practice address
4318 FORT ST, OMAHA, NE 68111
(402) 552-4707
Mailing address
4318 FORT ST, OMAHA, NE 68111-1849
(402) 552-4707
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2124
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
7366
MO
101YP2500X
Professional Counselor
Primary
2014001621
MO
101YP2500X
Professional Counselor
2124
NE
Other
Enumeration date
04/14/2014
Last updated
02/26/2019
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