Provider Demographics
NPI:1144086372
Name:SIRENA PSYCHOTHERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:SIRENA PSYCHOTHERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORAM
Authorized Official - Middle Name:DM
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-780-1661
Mailing Address - Street 1:7028 NORTH 102ND CIRCLE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-3059
Mailing Address - Country:US
Mailing Address - Phone:402-780-1661
Mailing Address - Fax:
Practice Address - Street 1:7028 NORTH 102ND CIRCLE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-3059
Practice Address - Country:US
Practice Address - Phone:402-780-1661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty