Provider Demographics
NPI:1245422195
Name:WELLMAN, KERRIE R (LIMHP, LMHC, LCPC)
Entity Type:Individual
Prefix:
First Name:KERRIE
Middle Name:R
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:LIMHP, LMHC, LCPC
Other - Prefix:
Other - First Name:KERRIE
Other - Middle Name:R
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LIMHP, LMHC, LCPC
Mailing Address - Street 1:11069 I ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1207
Mailing Address - Country:US
Mailing Address - Phone:402-933-4411
Mailing Address - Fax:
Practice Address - Street 1:11069 I ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1207
Practice Address - Country:US
Practice Address - Phone:402-933-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP0030101YM0800X
NE3521101YM0800X
IA079551101YM0800X
NE2036101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health