Provider Demographics
NPI:1083831945
Name:ABELS-ATHY, SUSAN LEA (MS, LMHP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LEA
Last Name:ABELS-ATHY
Suffix:
Gender:F
Credentials:MS, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2583
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2583
Mailing Address - Country:US
Mailing Address - Phone:308-234-6029
Mailing Address - Fax:308-237-4792
Practice Address - Street 1:3814 A AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8124
Practice Address - Country:US
Practice Address - Phone:308-234-6029
Practice Address - Fax:308-237-4792
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1830101YM0800X
NE97101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077781326Medicaid