Provider Demographics
NPI:1013807353
Name:FERNAU, ISABELLE KATHLEEN (PLMHP)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:KATHLEEN
Last Name:FERNAU
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 N 156TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-1440
Mailing Address - Country:US
Mailing Address - Phone:402-534-1602
Mailing Address - Fax:
Practice Address - Street 1:4141 N 156TH ST STE 201
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-1440
Practice Address - Country:US
Practice Address - Phone:402-534-1602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health