Provider Demographics
NPI:1255414603
Name:LEE, ADRIENNE R (LIMHP, LMFT)
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:R
Last Name:LEE
Suffix:
Gender:F
Credentials:LIMHP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 JANSSEN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1843
Mailing Address - Country:US
Mailing Address - Phone:402-890-8985
Mailing Address - Fax:402-434-9299
Practice Address - Street 1:4535 NORMAL BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5576
Practice Address - Country:US
Practice Address - Phone:402-890-8985
Practice Address - Fax:402-434-9299
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3309101YM0800X
NE961101YM0800X
NE121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE255190OtherMIDLANDS CHOICE