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Individual

MRS. JACQUELINE ANNE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.S, LMHP, LPC,

Contact information

Practice address
408 10TH ST, GOTHENBURG, NE 69138-1922
(308) 529-0821
Mailing address
RR 1 BOX 99, GOTHENBURG, NE 69138-9607
(308) 537-2585
(308) 537-2585

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2756
NE
101YP2500X
Professional Counselor
1465
NE
103TS0200X
School Psychologist
Primary
31858
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025003500
NE
Enumeration date
01/04/2007
Last updated
09/11/2025
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