Provider Demographics
NPI:1154494300
Name:WADDINGTON, TAUNI (LIMHP/1055,LADC/288,)
Entity Type:Individual
Prefix:MS
First Name:TAUNI
Middle Name:
Last Name:WADDINGTON
Suffix:
Gender:F
Credentials:LIMHP/1055,LADC/288,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4344 N 62ND ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-1227
Mailing Address - Country:US
Mailing Address - Phone:402-580-2692
Mailing Address - Fax:
Practice Address - Street 1:4344 N 62ND ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68507-1227
Practice Address - Country:US
Practice Address - Phone:402-580-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1685101Y00000X
NE288101YA0400X
NE1055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026609100Medicaid
NE47057655277Medicaid