Provider Demographics
NPI:1669825444
Name:LOTT, PATRICIA (PLMHP, PLADC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LOTT
Suffix:
Gender:F
Credentials:PLMHP, PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-1763
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 S 84TH ST
Practice Address - Street 2:STE. 212
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2680
Practice Address - Country:US
Practice Address - Phone:402-261-9273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1396101YA0400X
NE10601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10601OtherSTATE OF NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
NEP-1396OtherSTATE OF NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES