Individual
JACK EVERIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LIMHP LPC
Contact information
Practice address
459 S 6TH ST, BLUE VALLEY BEHAVIORAL HEALTH, SEWARD, NE 68434-2405
(402) 643-3343
(402) 643-4048
Mailing address
1900 SO 50TH ST, LINCOLN, NE 68506
(402) 643-2800
(402) 643-4048
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2275
NE
101YM0800X
Mental Health Counselor
563
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025207900
—
NE
05
—
10025208600
—
NE
05
—
10025668200
—
NE
01
—
237457
MIDLANDS CHOICE
—
05
—
470528515-00
—
NE
05
—
470528515-01
—
NE
05
—
470528515-02
—
NE
05
—
470528515-03
—
NE
05
—
470528515-04
—
NE
05
—
470528515-05
—
NE
05
—
470528515-06
—
NE
05
—
470528515-07
—
NE
05
—
470528515-08
—
NE
05
—
470528515-09
—
NE
05
—
470528515-10
—
NE
05
—
470528515-13
—
NE
05
—
470528515-14
—
NE
05
—
470528515-15
—
NE
05
—
470528515-17
—
NE
05
—
470528515-82
—
NE
05
—
47052851505
—
NE
01
—
84591
BCBS
NC
Enumeration date
11/14/2006
Last updated
05/16/2012
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