Provider Demographics
NPI:1992031488
Name:KENTOPP WESTBERG, STEPHANIE ANNE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNE
Last Name:KENTOPP WESTBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANNE
Other - Last Name:KENTOPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA (LMHP)
Mailing Address - Street 1:4545 S 86TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9227
Mailing Address - Country:US
Mailing Address - Phone:402-483-6900
Mailing Address - Fax:402-783-7045
Practice Address - Street 1:4545 S 86TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9227
Practice Address - Country:US
Practice Address - Phone:402-483-6900
Practice Address - Fax:402-783-7045
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3953101YM0800X
NE1957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional