Individual
SHANE MICHAEL POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LIMHP
Contact information
Practice address
11605 ARBOR ST STE 102, OMAHA, NE 68144-2982
(402) 330-0960
Mailing address
11605 ARBOR ST STE 102, OMAHA, NE 68144-2982
(402) 350-8302
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1896
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13671183
CAQH
—
Enumeration date
02/06/2013
Last updated
09/03/2019
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