Provider Demographics
NPI:1609972025
Name:DINNEEN, LONNIE R (LIMHP, LIMHP, LADC)
Entity Type:Individual
Prefix:
First Name:LONNIE
Middle Name:R
Last Name:DINNEEN
Suffix:
Gender:M
Credentials:LIMHP, LIMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8031 W CENTER RD
Mailing Address - Street 2:SUITE 324
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3158
Mailing Address - Country:US
Mailing Address - Phone:402-502-5002
Mailing Address - Fax:402-502-5102
Practice Address - Street 1:8031 W CENTER RD
Practice Address - Street 2:SUITE 324
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3158
Practice Address - Country:US
Practice Address - Phone:402-502-5002
Practice Address - Fax:402-502-5102
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE308101YA0400X
NE179106H00000X
NE44101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026158300Medicaid