Provider Demographics
NPI:1417045766
Name:KENNEL, LORRIE LYNN (LMHP)
Entity Type:Individual
Prefix:
First Name:LORRIE
Middle Name:LYNN
Last Name:KENNEL
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 1:140 N 8TH ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1351
Mailing Address - Country:US
Mailing Address - Phone:402-430-5119
Mailing Address - Fax:402-435-5119
Practice Address - Street 1:140 N 8TH ST
Practice Address - Street 2:SUITE 225
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1351
Practice Address - Country:US
Practice Address - Phone:402-430-5119
Practice Address - Fax:402-435-5119
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100252276-00Medicaid