Provider Demographics
NPI:1851629901
Name:LINCOLN BEHAVIORAL HEALTH CLINIC, INC
Entity Type:Organization
Organization Name:LINCOLN BEHAVIORAL HEALTH CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BYRNS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-489-9959
Mailing Address - Street 1:3201 PIONEERS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-5963
Mailing Address - Country:US
Mailing Address - Phone:402-489-9959
Mailing Address - Fax:402-489-2219
Practice Address - Street 1:202 N ESTHER ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:NE
Practice Address - Zip Code:68638-3029
Practice Address - Country:US
Practice Address - Phone:402-489-9959
Practice Address - Fax:402-489-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2340101YM0800X
NE746101YM0800X
NE289103T00000X
NE10491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty