Provider Demographics
NPI:1194245852
Name:MAGNUSSON, CLAUDIA (PLMHP)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MAGNUSSON
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2216
Mailing Address - Country:US
Mailing Address - Phone:786-400-5031
Mailing Address - Fax:
Practice Address - Street 1:327 ANN ST
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2411
Practice Address - Country:US
Practice Address - Phone:308-432-6910
Practice Address - Fax:308-432-8467
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health