Provider Demographics
NPI:1871820522
Name:SIEMER, KRIS J (LMHP, LADC)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:J
Last Name:SIEMER
Suffix:
Gender:F
Credentials:LMHP, LADC
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:J
Other - Last Name:DAISLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHP, LADC
Mailing Address - Street 1:12020 SHAMROCK PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3537
Mailing Address - Country:US
Mailing Address - Phone:402-500-0555
Mailing Address - Fax:888-960-2108
Practice Address - Street 1:12020 SHAMROCK PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3537
Practice Address - Country:US
Practice Address - Phone:402-500-0555
Practice Address - Fax:888-960-2108
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3536101YM0800X
NE860101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)