Individual
PAYTON JIBRI HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LIMHP
Contact information
Practice address
5858 WENNINGHOFF RD STE 2, OMAHA, NE 68134-1911
(402) 512-3475
(402) 206-2759
Mailing address
5858 WENNINGHOFF RD STE 2, OMAHA, NE 68134-1911
(402) 512-3475
(402) 206-2759
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1765
NE
101YM0800X
Mental Health Counselor
12129
NE
101YM0800X
Mental Health Counselor
Primary
2953
NE
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10027143800
—
NE
Enumeration date
02/25/2020
Last updated
12/11/2023
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