Provider Demographics
NPI:1972711224
Name:CORE CONDITIONS, P.C.
Entity type:Organization
Organization Name:CORE CONDITIONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT, LIMHP
Authorized Official - Phone:402-577-0727
Mailing Address - Street 1:11225 DAVENPORT ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2641
Mailing Address - Country:US
Mailing Address - Phone:402-577-0727
Mailing Address - Fax:402-881-8332
Practice Address - Street 1:11225 DAVENPORT ST
Practice Address - Street 2:SUITE 103
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2641
Practice Address - Country:US
Practice Address - Phone:402-577-0727
Practice Address - Fax:402-881-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty