Provider Demographics
NPI:1831633171
Name:SEXTRO, KARLA JEAN (LIMHP)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:JEAN
Last Name:SEXTRO
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-398-6248
Mailing Address - Fax:402-829-8513
Practice Address - Street 1:7101 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2164
Practice Address - Country:US
Practice Address - Phone:402-572-2916
Practice Address - Fax:402-572-3258
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1946101YM0800X
NE4865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health