Organization
LUMINOSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA RAE SURBER LMHP (OWNER)
(402) 650-6214
Entity
Organization
Contact information
Practice address
301 BROADWAY ST, CONCORD, NE 68728-2841
(402) 650-6214
Mailing address
301 BROADWAY ST, CONCORD, NE 68728-2841
(402) 650-6214
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3071
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025530800
—
NE
Enumeration date
01/30/2012
Last updated
01/30/2012
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