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Individual

MR. SHANE M BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LIMHP, LADC

Contact information

Practice address
12020 SHAMROCK PLZ STE 200, OMAHA, NE 68154-3537
(402) 522-6570
(402) 625-0410
Mailing address
12020 SHAMROCK PLZ STE 200, OMAHA, NE 68154-3537
(402) 522-6570
(402) 625-0410

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1116
NE
101YM0800X
Mental Health Counselor
Primary
1254
NE

Other

Enumeration date
02/27/2007
Last updated
09/06/2023
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