Individual
SUE BACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW/LMHP
Contact information
Practice address
8021 CHICAGO ST, OMAHA, NE 68114-3533
(402) 502-1024
(402) 502-1555
Mailing address
8021 CHICAGO ST, OMAHA, NE 68114-3533
(402) 502-1024
(402) 502-1555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
733
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025200300
—
NE
01
—
85251
BC/BS IDENTIFICATION NUMB
NE
Enumeration date
09/30/2006
Last updated
07/09/2007
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