Provider Demographics
NPI:1689748832
Name:SAUNDERS, OWEN LYNN (EDD)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:LYNN
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S 40TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5248
Mailing Address - Country:US
Mailing Address - Phone:402-441-9280
Mailing Address - Fax:
Practice Address - Street 1:1919 S 40TH ST STE 212
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5248
Practice Address - Country:US
Practice Address - Phone:402-441-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1366101YM0800X
NE917101YP2500X
NE2005004217103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8700OtherMIDLANDS INS
NE47075636926Medicaid
NE84288OtherBLUE CROSS & BLUE SHIELD
NE8700OtherMIDLANDS INSURANCE #
NE47075636926Medicaid