1932224193 NPI number — MS. JOLANE JEANNE LUETCHENS MS LMHP LMFT

Table of content: MS. JOLANE JEANNE LUETCHENS MS LMHP LMFT (NPI 1932224193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932224193 NPI number — MS. JOLANE JEANNE LUETCHENS MS LMHP LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUETCHENS
Provider First Name:
JOLANE
Provider Middle Name:
JEANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS LMHP LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAKLEY
Provider Other First Name:
JOLANE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932224193
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
718 EASTRIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-489-9933
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4535 NORMAL BLVD
Provider Second Line Business Practice Location Address:
STE 222
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-489-9933
Provider Business Practice Location Address Fax Number:
402-489-9936
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LMHP992 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT 08 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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