Provider Demographics
NPI:1093854127
Name:EILERS, KATHRYN RENEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RENEE
Last Name:EILERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:RENEE
Other - Last Name:BAUERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5905 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2235
Mailing Address - Country:US
Mailing Address - Phone:402-436-1301
Mailing Address - Fax:402-458-3297
Practice Address - Street 1:2229 J ST
Practice Address - Street 2:COUNSELING CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-6851
Practice Address - Country:US
Practice Address - Phone:402-436-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3287101YM0800X
12541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE97109OtherBCBS