Individual
MRS. NICOLE LYNNE PETESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2702 W 11TH ST, KEARNEY, NE 68845-0102
(308) 698-8060
Mailing address
2702 W 11TH ST, KEARNEY, NE 68845-0102
(308) 698-8060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-687
NE
101YM0800X
Mental Health Counselor
8087
NE
1041C0700X
Clinical Social Worker
6520
NE
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
05/09/2008
Last updated
03/07/2019
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