Individual ProviderSusan Diane NelsenCounselorBehavioral Health & Social Service ProvidersPractice Address11920 Burt Street, #190, Omaha, NE 68154(402) 965-4004PECOS EnrollmentBased on the most recent information from CMS, provider Susan Diane Nelsen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:51 AM.Profile DetailsProvider ID1861509952Provider TypeIndividualFull NameNelsen, Susan DianeTitleMs.CredentialMS, LMHP, CPC, NCCGenderFemaleSole ProprietorNoEnumeration Date8/24/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address11920 Burt Street, #190, Omaha, NE 68154Phone(402) 965-4004Fax(402) 965-4232Mailing LocationMailing Address11920 Burt Street, #190, Omaha, NE 68154Phone(402) 965-4004Fax(402) 965-4232Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense1546NebraskaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense957NebraskaProvider IdentifiersIDDescriptionIssuerID84677DescriptionOtherIssuerBLUECROSS BLUESHIELDNebraskaID100253006-00DescriptionMedicaidIssuerUnlistedNebraska