Provider Demographics
NPI:1548319437
Name:PATERSON, ENETTE (LMHP)
Entity type:Individual
Prefix:
First Name:ENETTE
Middle Name:
Last Name:PATERSON
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ARAPAHOE ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-4417
Mailing Address - Country:US
Mailing Address - Phone:402-476-5202
Mailing Address - Fax:402-476-5202
Practice Address - Street 1:1101 ARAPAHOE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-4417
Practice Address - Country:US
Practice Address - Phone:402-476-5202
Practice Address - Fax:402-476-5202
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2984101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100253669-00Medicaid