Individual
SHANE CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHP
Contact information
Practice address
8101 O ST, SUITE 214, LINCOLN, NE 68510-2646
(402) 488-1032
(402) 484-8545
Mailing address
8101 O ST, SUITE 214, LINCOLN, NE 68510-2646
(402) 488-1032
(402) 484-8545
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2966
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025109200
—
NE
Enumeration date
07/18/2006
Last updated
07/08/2007
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