Provider Demographics
NPI:1245664275
Name:MURTAUGH, LACEE (PLMHP)
Entity type:Individual
Prefix:
First Name:LACEE
Middle Name:
Last Name:MURTAUGH
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-0446
Mailing Address - Country:US
Mailing Address - Phone:402-878-2911
Mailing Address - Fax:402-878-2027
Practice Address - Street 1:100 BLUFF AVE
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-9787
Practice Address - Country:US
Practice Address - Phone:402-878-2911
Practice Address - Fax:402-878-2027
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9868101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health