Provider Demographics
NPI:1295701068
Name:HUBBARD, SHERRY LYNNE (MS LIMHP MFT PC)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNNE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MS LIMHP MFT PC
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:LYNNE
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1406 FORT CROOK RD S
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2992
Mailing Address - Country:US
Mailing Address - Phone:402-292-7712
Mailing Address - Fax:402-292-0144
Practice Address - Street 1:1406 FORT CROOK RD S
Practice Address - Street 2:SUITE 401
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2992
Practice Address - Country:US
Practice Address - Phone:402-292-7712
Practice Address - Fax:402-292-0144
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE520101YM0800X, 106H00000X
NE398101YP2500X
NE65106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE84862OtherBLUE CROSS BLUE SHIELD
NE9085OtherMIDLANDS CHOICE
NE7949569OtherAETNA
NE198788OtherMHN
NE84682Medicaid
NE84862OtherBLUE CROSS BLUE SHIELD