Individual
DUOL WUOW RUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LIMHP/LPC
Contact information
Practice address
650 J ST STE 15, LINCOLN, NE 68508-2916
(402) 433-0052
(402) 442-0065
Mailing address
650 J ST STE 15, LINCOLN, NE 68508-2916
(402) 433-0052
(402) 442-0065
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2353
NE
101YP2500X
Professional Counselor
2561
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025496501
—
NE
Enumeration date
01/05/2008
Last updated
04/17/2020
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