Organization
SJA MENAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA ACOSTA LIMHP, LMFT (THERAPIST)
(435) 238-0331
Entity
Organization
Contact information
Practice address
18718 JOSEPHINE ST, OMAHA, NE 68136-1263
(435) 238-0331
Mailing address
18718 JOSEPHINE ST, OMAHA, NE 68136-1263
(435) 238-0331
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55499635806
—
NE
Enumeration date
03/07/2019
Last updated
03/07/2019
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