Provider Demographics
NPI:1063461648
Name:HEROLD, BRANDI LEE (LIMHP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:LEE
Last Name:HEROLD
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:LEE
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP
Mailing Address - Street 1:835 S. BURLINGTON STE #107
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901
Mailing Address - Country:US
Mailing Address - Phone:402-462-4200
Mailing Address - Fax:402-462-4201
Practice Address - Street 1:835 S. BURLINGTON STE #107
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901
Practice Address - Country:US
Practice Address - Phone:402-462-4200
Practice Address - Fax:402-462-4201
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2082101YM0800X
NE2253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47037877928Medicaid