Provider Demographics
NPI:1922425701
Name:WRENN, KRISSI K (LMHP, LCSW)
Entity Type:Individual
Prefix:
First Name:KRISSI
Middle Name:K
Last Name:WRENN
Suffix:
Gender:F
Credentials:LMHP, LCSW
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:K
Other - Last Name:WRENN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHP, LCSW
Mailing Address - Street 1:4915 W MCGUIRE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68524-1146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2534 A ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-1838
Practice Address - Country:US
Practice Address - Phone:402-484-6759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4811041C0700X
NE5441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical