Provider Demographics
NPI:1548339302
Name:DAVIS, CLAUDIA JAN (LMHP CPC)
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:JAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMHP CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 NW 126 ST
Mailing Address - Street 2:
Mailing Address - City:MALCOLM
Mailing Address - State:NE
Mailing Address - Zip Code:68402
Mailing Address - Country:US
Mailing Address - Phone:402-796-2308
Mailing Address - Fax:
Practice Address - Street 1:543 N LINDEN ST
Practice Address - Street 2:BLUE VALLEY BEHAVIORAL HEALTH
Practice Address - City:WAHOO
Practice Address - State:NE
Practice Address - Zip Code:68066-1960
Practice Address - Country:US
Practice Address - Phone:402-228-3386
Practice Address - Fax:402-443-4414
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1084101YM0800X
NE847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470528515-17Medicaid
NE10025208700Medicaid
NE470528515-05Medicaid
NE470528515-08Medicaid
NE10025208000Medicaid
NE470528515-00Medicaid
NE470528515-14Medicaid
NE84730OtherBCBS
NE470528515-09Medicaid
NE470528515-15Medicaid
NE9595OtherMIDLANDS CHOICE
NE470528515-03Medicaid
NE470528515-04Medicaid
NE470528515-07Medicaid
NE470528515-13Medicaid
NE470528515-06Medicaid
NE470528515-10Medicaid
NE470528515-01Medicaid
NE470528515-02Medicaid