Provider Demographics
NPI:1225155492
Name:BLUNT, LISA K (LMHP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:K
Last Name:BLUNT
Suffix:
Gender:F
Credentials:LMHP
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 292
Mailing Address - Street 2:
Mailing Address - City:WEEPING WATER
Mailing Address - State:NE
Mailing Address - Zip Code:68463-0292
Mailing Address - Country:US
Mailing Address - Phone:402-267-5138
Mailing Address - Fax:402-267-5138
Practice Address - Street 1:115 S 46TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3229
Practice Address - Country:US
Practice Address - Phone:402-504-3609
Practice Address - Fax:402-553-6000
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health