Provider Demographics
NPI:1720471253
Name:FLEWELLING, NICHOLAS (LIMHP,LMHP,CMSW)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:FLEWELLING
Suffix:
Gender:M
Credentials:LIMHP,LMHP,CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2467
Mailing Address - Country:US
Mailing Address - Phone:402-853-1224
Mailing Address - Fax:
Practice Address - Street 1:1430 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2467
Practice Address - Country:US
Practice Address - Phone:402-853-1224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5796101YM0800X
NE12234101YM0800X
NE21131041C0700X
NE74891041C0700X
172V00000X
NE2962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker