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Individual

JAY DOMINIC PATIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LMHP, NCC

Contact information

Practice address
13460 WALSH DR, BOYS TOWN, NE 68010-7529
(402) 498-3358
(402) 498-3375
Mailing address
608 N 50TH ST APT 101, OMAHA, NE 68132-2245
(402) 321-5805

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3441
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025745300
NE
05
10026139700
NE
05
47037660631
NE
Enumeration date
12/21/2006
Last updated
10/02/2017
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