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Individual

MR. LEE DERRICK CLAUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7300 S 40TH ST, LINCOLN, NE 68516-3010
(402) 416-0625
Mailing address
7300 S 40TH ST, LINCOLN, NE 68516-3010
(402) 416-0625

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1938
NE
101YM0800X
Mental Health Counselor
Primary
12840
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026909200
NE
Enumeration date
01/21/2022
Last updated
01/21/2022
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