Provider Demographics
NPI:1770589962
Name:VOGEL, LISA (MSED,ATR ,LIMHP,LMHC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MSED,ATR ,LIMHP,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134
Mailing Address - Country:US
Mailing Address - Phone:402-393-0133
Mailing Address - Fax:402-391-0498
Practice Address - Street 1:9105 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4723
Practice Address - Country:US
Practice Address - Phone:402-393-0133
Practice Address - Fax:402-391-0498
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
89-182101Y00000X
43725101YM0800X
NE908101YM0800X
NE1189101YM0800X
IA00363101YM0800X
NE1406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE84260OtherBLUECROSS BLUESHIELD