Provider Demographics
NPI:1518014869
Name:NIEMANN, CAROL J (LMHP PC PLADC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:NIEMANN
Suffix:
Gender:F
Credentials:LMHP PC PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N 23RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521
Mailing Address - Country:US
Mailing Address - Phone:402-416-9802
Mailing Address - Fax:
Practice Address - Street 1:4000 N 23ERD ST.
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521
Practice Address - Country:US
Practice Address - Phone:402-416-9802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP285101YA0400X
NE1389101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE71857000OtherMAGELLAN
NE10025070900Medicaid
NE85161OtherBCBS