Individual
SHAWNENE JAYNE NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1313 FARNAM ST, OMAHA, NE 68102-1881
(208) 329-3646
Mailing address
PO BOX 8232, OMAHA, NE 68108-0232
(208) 329-3646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CERTIF 10089 REF 743
ID
104100000X
Social Worker
LMSW-24582
ID
1041C0700X
Clinical Social Worker
Primary
LCSW31784
ID
1041C0700X
Clinical Social Worker
LICSW 1433
NE
1041C0700X
Clinical Social Worker
LIMHP 964
NE
1041S0200X
School Social Worker
IDAHO
ID
1041S0200X
School Social Worker
LMSW-24582
ID
Other
Enumeration date
09/03/2010
Last updated
11/01/2012
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