DEBORAH M ELLISON AMBURN


Address: 3020 18t Street, Ste 17, Columbus, NE 68601
Phone: 4025633833

DEBORAH M ELLISON AMBURN (NPI# 1184790776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184790776
Entity Type Individual
Full Name DEBORAH M ELLISON AMBURN
Other Name DEBORAH M RINGEISEN
Credential MA LADC LMHP
Practice Address 3020 18t Street
Ste 17
Columbus
NE 68601
Mailing Address 3300 N 60th St
Omaha
NE 68104
Practice Telephone 4025633833
Practice Fax Number 4025628714
Mailing Telephone 4025540520
Mailing Fax Number 4025518797
Enumeration Date 2006-11-27
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
269 NE Behavioral Health & Social Service Providers
X 101YM0800X Counselor
Specialization: Mental Health
1380 NE Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NE 47037661202 05
NE BCBS 85513 01
NE 100253156100 05

Office Location

Street Address 3020 18T STREET
STE 17
City COLUMBUS
State NE
Zip Code 68601

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City COLUMBUS
Zip Code 68601

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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