Provider Demographics
NPI:1407985823
Name:EMOTIONAL HEALTH CLINIC OF LINCOLN, P.C.
Entity Type:Organization
Organization Name:EMOTIONAL HEALTH CLINIC OF LINCOLN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:402-488-2141
Mailing Address - Street 1:4829 CALVERT ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4829 CALVERT ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3905
Practice Address - Country:US
Practice Address - Phone:402-488-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========26Medicaid