Provider Demographics
NPI:1558037390
Name:LUTZ-PRIEFERT, MARY (LMHP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:LUTZ-PRIEFERT
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:LUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10321 BROADMOOR CT APT 913
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4835
Mailing Address - Country:US
Mailing Address - Phone:402-730-5525
Mailing Address - Fax:
Practice Address - Street 1:9223 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4725
Practice Address - Country:US
Practice Address - Phone:531-213-7396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE774101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional