Provider Demographics
NPI:1477196855
Name:KAUP, MERRIDIE R (LMHP)
Entity Type:Individual
Prefix:
First Name:MERRIDIE
Middle Name:R
Last Name:KAUP
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:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-0151
Mailing Address - Country:US
Mailing Address - Phone:402-395-2191
Mailing Address - Fax:
Practice Address - Street 1:723 W FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-1725
Practice Address - Country:US
Practice Address - Phone:402-395-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health