Provider Demographics
NPI:1598922338
Name:KAGAN, LAWRENCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:KAGAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S 70TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-7905
Mailing Address - Country:US
Mailing Address - Phone:402-489-7722
Mailing Address - Fax:402-488-7784
Practice Address - Street 1:1001 S 70TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-7905
Practice Address - Country:US
Practice Address - Phone:402-489-7722
Practice Address - Fax:402-488-7784
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE120103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical