Provider Demographics
NPI:1881879195
Name:RUT, DUOL WUOW (MA, LIMHP/LPC)
Entity type:Individual
Prefix:
First Name:DUOL
Middle Name:WUOW
Last Name:RUT
Suffix:
Gender:M
Credentials:MA, LIMHP/LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 J ST STE 15
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2916
Mailing Address - Country:US
Mailing Address - Phone:402-433-0052
Mailing Address - Fax:402-442-0065
Practice Address - Street 1:650 J ST STE 15
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2916
Practice Address - Country:US
Practice Address - Phone:402-433-0052
Practice Address - Fax:402-442-0065
Is Sole Proprietor?:No
Enumeration Date:2008-01-05
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2561101YP2500X
NE2353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025496501Medicaid
NE47075636998Medicaid
NE10026038300Medicaid
NE47075636930Medicaid
NE10025734000Medicaid