Provider Demographics
NPI:1003945973
Name:WERNER, MARY E (LMSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:WERNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67250
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7250
Mailing Address - Country:US
Mailing Address - Phone:402-328-8833
Mailing Address - Fax:402-328-2921
Practice Address - Street 1:4535 NORMAL BLVD.
Practice Address - Street 2:STE. 222
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2891
Practice Address - Country:US
Practice Address - Phone:402-327-9944
Practice Address - Fax:402-483-4294
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE446101YM0800X
NE8951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8468OtherMIDLANDS CHOICE
NE10025552100Medicaid
NE82463OtherBCBS
NE10025552100Medicaid