Provider Demographics
NPI:1063717973
Name:STAHLECKER, REBECCA L (LIMHP, LADC, LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:STAHLECKER
Suffix:
Gender:F
Credentials:LIMHP, LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W PASEWALK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5656
Mailing Address - Country:US
Mailing Address - Phone:402-500-6870
Mailing Address - Fax:402-500-6871
Practice Address - Street 1:3805 25TH ST STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2233
Practice Address - Country:US
Practice Address - Phone:402-500-6870
Practice Address - Fax:402-500-6871
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1045101YA0400X
NE2096101YP2500X
NE1422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470831659-26Medicaid