Provider Demographics
NPI:1831383710
Name:LINCOLN COUNSELING CENTER, P.C.
Entity type:Organization
Organization Name:LINCOLN COUNSELING CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:402-327-9944
Mailing Address - Street 1:PO BOX 67250
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7250
Mailing Address - Country:US
Mailing Address - Phone:402-328-8833
Mailing Address - Fax:402-328-2921
Practice Address - Street 1:4535 NORMAL BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2891
Practice Address - Country:US
Practice Address - Phone:402-327-9944
Practice Address - Fax:402-483-4294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025303500Medicaid
NE10025552100Medicaid
NE10025552100Medicaid