Individual
MS. CAROL COUNTRYMAN NUNNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW LIMHP
Contact information
Practice address
4444 S 86TH T STE 102, LINCOLN, NE 68526-9253
(402) 476-7557
(402) 476-9912
Mailing address
PO BOX 57475, LINCOLN, NE 68505
(402) 429-5365
(402) 476-9912
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
67
NE
1041C0700X
Clinical Social Worker
1136
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025273400
—
NE
01
—
798299000
MAGELLAN
NE
01
—
85299
BCBS
NE
Enumeration date
12/13/2006
Last updated
10/25/2023
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