Individual
MRS. LEANN MAXINE TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.MHP, LPC
Contact information
Practice address
1919 S 40TH ST, SUITE 212, LINCOLN, NE 68506-5243
(402) 441-9280
(402) 441-9279
Mailing address
1919 S 40TH ST, SUITE 212, LINCOLN, NE 68506-5243
(402) 441-9280
(402) 441-9279
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3704
NE
101YM0800X
Mental Health Counselor
8555
NE
101YP2500X
Professional Counselor
1843
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
456304000
MAGELLAN MANAGED CARE
NE
05
—
456304000
—
NE
05
—
470756369-26
—
NE
05
—
470774254-26
—
NE
01
—
96079
BLUECROSS & BLUE SHIELD
NE
Enumeration date
02/27/2008
Last updated
04/08/2010
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