Provider Demographics
NPI:1689262990
Name:PHELPS, CAITLIN (LMHP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:PHELPS
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 1:2320 S 48TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5513
Mailing Address - Country:US
Mailing Address - Phone:402-613-2162
Mailing Address - Fax:
Practice Address - Street 1:2320 S 48TH ST STE 230
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5515
Practice Address - Country:US
Practice Address - Phone:402-613-2162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health