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Individual

SCOTT HALVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
501 TYSON ST, GLENWOOD, IA 51534-1735
(712) 527-3030
Mailing address
988095 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8095
(402) 559-9800

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
545
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
545
STATE LICENSE
NE
Enumeration date
12/13/2006
Last updated
07/08/2007
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