Provider Demographics
NPI:1255497830
Name:LUNDQUIST, JUDITH ROBERTSON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ROBERTSON
Last Name:LUNDQUIST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11605 ARBOR ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2982
Mailing Address - Country:US
Mailing Address - Phone:402-330-4700
Mailing Address - Fax:402-330-8815
Practice Address - Street 1:11605 ARBOR ST
Practice Address - Street 2:SUITE 106
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2982
Practice Address - Country:US
Practice Address - Phone:402-330-4700
Practice Address - Fax:402-330-8815
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE369101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional