Provider Demographics
NPI:1568504793
Name:O'DONNELL, KATHRYN LYNN (LCSW, LIMHP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LYNN
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:LCSW, LIMHP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:L
Other - Last Name:SMERSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1123 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-2041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 W 19TH ST
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355-2011
Practice Address - Country:US
Practice Address - Phone:402-245-4458
Practice Address - Fax:402-245-4459
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
82576OtherBLUE CROSS BLUE SHIELD