Provider Demographics
NPI:1669410668
Name:UDEN, KRISHA SUE (MS LMHP LPC LIMHP)
Entity type:Individual
Prefix:MRS
First Name:KRISHA
Middle Name:SUE
Last Name:UDEN
Suffix:
Gender:F
Credentials:MS LMHP LPC LIMHP
Other - Prefix:MISS
Other - First Name:KRISHA
Other - Middle Name:SUE
Other - Last Name:NIEMOTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS LMHP LPC LIMHP
Mailing Address - Street 1:PO BOX 5401
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5401
Mailing Address - Country:US
Mailing Address - Phone:308-379-1958
Mailing Address - Fax:866-234-6903
Practice Address - Street 1:1932 ASPEN CIR
Practice Address - Street 2:SUITE J
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2353
Practice Address - Country:US
Practice Address - Phone:308-379-1958
Practice Address - Fax:866-234-6903
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1936101Y00000X
NE1119101Y00000X
NE227101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE299164000OtherMAGELLAN MIS #