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Individual

MS. KIMBERLY S. HAVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA, ACADC; LADC

Contact information

Practice address
2808 N 75TH ST, SUITE H, OMAHA, NE 68134-6861
(402) 932-9412
(402) 932-3557
Mailing address
2808 N 75TH ST, SUITE H, OMAHA, NE 68134-6861
(402) 932-9412
(402) 932-3557

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
09132
IA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
896
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01015
CADC
IA
Enumeration date
12/28/2006
Last updated
06/22/2011
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