Provider Demographics
NPI:1659445435
Name:ROOK, KELLY J (LMHP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:J
Last Name:ROOK
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 A ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4289
Mailing Address - Country:US
Mailing Address - Phone:402-770-2969
Mailing Address - Fax:
Practice Address - Street 1:7121 A ST
Practice Address - Street 2:STE. 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4289
Practice Address - Country:US
Practice Address - Phone:402-770-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health