Organization
TIFFANY D. KOENEN, LCSW, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY DAWN KOENEN LCSW (PRESIDENT)
(402) 502-1024
Entity
Organization
Contact information
Practice address
8021 CHICAGO ST, OMAHA, NE 68114-3533
(402) 502-1024
(402) 502-1555
Mailing address
8021 CHICAGO ST, OMAHA, NE 68114-3533
(402) 502-1024
(402) 502-1555
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1028
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025455400
—
NE
Enumeration date
07/03/2007
Last updated
08/22/2020
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