Individual
MR. JEROME RALPH BARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHP LADC
Contact information
Practice address
1650 LAKE ST, BRYAN LGH INDEPENDENCE CENTER, LINCOLN, NE 68502
(402) 481-5881
(402) 481-5495
Mailing address
1650 LAKE ST, BRYAN LGH INDEPENDENCE CENTER, LINCOLN, NE 68502
(402) 481-5881
(402) 481-5495
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LADC # 117
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LMHP # 228
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47057655277
—
NE
Enumeration date
11/16/2006
Last updated
07/08/2007
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