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Individual

MAUREEN SUSMITA SAMUEL RAVURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LIMHP, LPC, NCC

Contact information

Practice address
4383 NICHOLAS ST, OMAHA, NE 68131-1008
(402) 819-7868
Mailing address
10845 HARNEY ST, OMAHA, NE 68154-2637
(402) 819-7868

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3908
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042622756
CCA
MA
01
1134107113
BEACON
MA
05
1134107113
MA
01
12529
HNE
MA
01
71756
TUFTS
MA
01
997303
NETWORK HEALTH
MA
01
Y10086
MEDICARE
MA
Enumeration date
02/06/2019
Last updated
06/10/2025
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