Provider Demographics
NPI:1821641044
Name:TINA LILJEHORN, LCSW
Entity Type:Organization
Organization Name:TINA LILJEHORN, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LILJEHORN
Authorized Official - Suffix:
Authorized Official - Credentials:CMSW, LCSW, LMHP
Authorized Official - Phone:402-499-8793
Mailing Address - Street 1:1925 W APRICOT LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-4423
Mailing Address - Country:US
Mailing Address - Phone:402-499-8793
Mailing Address - Fax:
Practice Address - Street 1:1240 N 10TH ST STE 2
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1125
Practice Address - Country:US
Practice Address - Phone:402-747-1412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty