Provider Demographics
NPI:1467760413
Name:KUDRNA, LAUNA JEAN (CMSW, LMHP)
Entity Type:Individual
Prefix:
First Name:LAUNA
Middle Name:JEAN
Last Name:KUDRNA
Suffix:
Gender:F
Credentials:CMSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 N PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-3563
Mailing Address - Country:US
Mailing Address - Phone:402-720-8889
Mailing Address - Fax:
Practice Address - Street 1:1236 N PLATTE AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3563
Practice Address - Country:US
Practice Address - Phone:402-720-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE80-0645320OtherEIN # 80-0645320