Provider Demographics
NPI:1609325372
Name:LCG AND ASSOCIATES
Entity Type:Organization
Organization Name:LCG AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WIGINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-677-5595
Mailing Address - Street 1:2437 S 130TH CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2528
Mailing Address - Country:US
Mailing Address - Phone:402-677-5595
Mailing Address - Fax:
Practice Address - Street 1:2437 S 130TH CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2528
Practice Address - Country:US
Practice Address - Phone:402-677-5595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty