Provider Demographics
NPI:1891582318
Name:BELLER, SHUMAIN (PLMHP)
Entity type:Individual
Prefix:
First Name:SHUMAIN
Middle Name:
Last Name:BELLER
Suffix:
Gender:
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18315 BURDETTE ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-7022
Mailing Address - Country:US
Mailing Address - Phone:402-658-8889
Mailing Address - Fax:
Practice Address - Street 1:11819 MIRACLE HILLS DR STE 203
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4428
Practice Address - Country:US
Practice Address - Phone:402-414-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health