Individual
MS. JODI LYN PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, NCC, LMHP, LPC
Contact information
Practice address
11330 Q STREET, STE 205, OMAHA, NE 68137
(402) 597-2126
(402) 597-2326
Mailing address
11330 Q STREET, STE 205, OMAHA, NE 68137
(402) 597-2126
(402) 597-2326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3080
NE
101YM0800X
Mental Health Counselor
Primary
LMHP 3080
NE
101YM0800X
Mental Health Counselor
LPC 1600
NE
Other
Enumeration date
01/31/2007
Last updated
04/15/2009
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