Individual
KELLY BAULISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP, LPC, LADC
Contact information
Practice address
1490 N 16TH ST, OMAHA, NE 68102-4101
(402) 827-0570
(402) 827-0577
Mailing address
3300 N 60TH ST, OMAHA, NE 68104-3402
(402) 554-0520
(402) 551-8797
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8951
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47082303526
—
NE
Enumeration date
07/10/2008
Last updated
01/05/2015
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