Provider Demographics
NPI:1447640909
Name:BEDFORD HANSEN, AUDRE J
Entity type:Individual
Prefix:
First Name:AUDRE
Middle Name:J
Last Name:BEDFORD HANSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUDRE
Other - Middle Name:J
Other - Last Name:BEDFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5700 THOMPSON CREEK BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6579
Mailing Address - Country:US
Mailing Address - Phone:402-327-1085
Mailing Address - Fax:
Practice Address - Street 1:5700 THOMPSON CREEK BLVD STE 3
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6579
Practice Address - Country:US
Practice Address - Phone:402-327-1085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2271101YA0400X
NE14233101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)