Organization
SOUTHERN SUDAN COMM ASS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA H ALLEN LMHP (SUPERVISING LMHP)
(402) 554-0759
Entity
Organization
Contact information
Practice address
3610 DODGE STREET, SUITE 100, OMAHA, NE 68131
(402) 554-0759
(402) 561-9724
Mailing address
3610 DODGE STREET, SUITE 100, OMAHA, NE 68131
(402) 554-0759
(402) 561-9724
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025485800
—
NE
Enumeration date
03/22/2007
Last updated
08/22/2020
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