Provider Demographics
NPI:1972818631
Name:LORD, JULIA EILEEN (LMHP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:EILEEN
Last Name:LORD
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:EILEEN
Other - Last Name:KORAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3300 N 60TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3402
Mailing Address - Country:US
Mailing Address - Phone:402-829-9283
Mailing Address - Fax:
Practice Address - Street 1:3300 N 60TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3402
Practice Address - Country:US
Practice Address - Phone:402-829-9283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470765107Medicaid