MRS. SHANNON BOLTER (NPI# 1376177071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376177071 |
| Entity Type | Individual |
| Full Name | MRS. SHANNON BOLTER |
| Credential | PLADC |
| Practice Address |
11550 I St Omaha NE 68137-1262 |
| Practice Telephone | 4022014288 |
| Mailing Telephone | 4022014288 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
P-1615 | NE | Behavioral Health & Social Service Providers |
| Street Address |
11550 I ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68137-1262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801211164 | Lucy Ajuoga | Counselor | 11550 I St, Suite 100, Omaha, NE 68137-1262 | 2014-02-24 |
| 1780202689 | Alicia Mae Villescas | Counselor | 11550 I St, Omaha, NE 68137-1262 | 2020-07-08 |
| 1366920209 | Kirby Janae Davis | Counselor | 11550 I St, Omaha, NE 68137-1262 | 2018-08-02 |
| 1407380280 | Kvc Behavioral Health | Counselor | 11550 I St, 100, Omaha, NE 68137-1262 | 2017-04-18 |
| 1952833386 | Stephanie Clark | Social Worker | 11550 I St, Suite 100, Omaha, NE 68137-1262 | 2017-04-03 |
| 1164875779 | Larissa Dowe | Social Worker | 11550 I St, Omaha, NE 68137-1262 | 2016-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740803022 | Marcia Marie Malone | Nurse Practitioner | 5045 S 153rd St, Omaha, NE 68137 | 2020-05-21 |
| 1528626991 | Millard Family Hospital, LLC | Emergency Medicine | 14404 Stoney Brook Blvd, Omaha, NE 68137 | 2019-05-31 |
| 1104390855 | Millard Hills Dental Health Center LLC | Dentist | 14202 Y Street, Omaha, NE 68137 | 2019-01-16 |
| 1740750389 | Brett Skof | Specialist/Technologist | 6607 South 108th Court #210, Omaha, NE 68137 | 2018-11-27 |
| 1801374491 | Walnut Creek LLC | Pharmacy | 11020 Q Street, Omaha, NE 68137 | 2018-08-06 |
| 1326567686 | Lachelle Zuhlke | Psychologist | 5606 S. 147th Street, Omaha, NE 68137 | 2017-09-18 |
| 1043739766 | Rachel Miller | Registered Nurse | 5606 S. 147th St, Omaha, NE 68137 | 2017-09-13 |
| 1972029338 | Jill Marie Anderson | Social Worker | 5606 South 147th Street, Omaha, NE 68137 | 2017-08-17 |
| 1790153617 | Answers for Autism, LLC | Community/Behavioral Health | 6424 S 150th St., Omaha, NE 68137 | 2015-09-09 |
| 1912382383 | Rocky Mountain Holdings, LLC | Ambulance | 12916 Millard Airport Plz, Omaha, NE 68137 | 2015-07-27 |
| Find all providers in zip 68137 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930386 | Harry D Washington IIi | Counselor | 1299 Farnam, Omaha, NE 68105-6811 | 2020-07-23 |
| 1003432386 | Judi Scott | Counselor | 9733 Grant St, Omaha, NE 68134-5619 | 2020-06-22 |
| 1508481086 | William Sean Mcneil | Counselor | 3128 N 168th Ave, Omaha, NE 68116-2614 | 2020-06-10 |
| 1063048114 | Tiffany Gormley | Counselor | 18047 Oak St, Omaha, NE 68130-6093 | 2020-03-20 |
| 1851939565 | Mat Lavern Zollicoffer | Counselor | 1502 N 58th St, Omaha, NE 68104-4820 | 2019-12-12 |
| 1184269235 | Gary Darryl Mosley Sr. | Counselor | Tamarak Building Suite 101 G, 3035 Harney Street, Omaha, NE 68131-3500 | 2019-11-13 |
| 1437792439 | Lisa Ann Osler | Counselor | 1301 S 31st St Apt 15, Omaha, NE 68105-2048 | 2019-10-22 |
| 1154970176 | Loren Dexter | Counselor | 13808 U St, Omaha, NE 68137-2904 | 2019-09-11 |
| 1912550823 | Kelley A Lutjen | Counselor | 401 S 39th St, Omaha, NE 68131-3710 | 2019-07-19 |
| 1356908735 | David Brinkerhoff Ballard IIi | Counselor | 902 N 95th Plz Apt 5, Omaha, NE 68114-2561 | 2019-05-21 |
| Find all providers in OMAHA | ||||
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| 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.