MS. KELLEY A LUTJEN (NPI# 1912550823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912550823 |
| Entity Type | Individual |
| Full Name | MS. KELLEY A LUTJEN |
| Credential | PLADC |
| Practice Address |
401 S 39th St Omaha NE 68131-3710 |
| Mailing Address |
1051 Ohio St Apt D Fremont NE 68025-2165 |
| Practice Telephone | 4025587088 |
| Practice Fax Number | 4025587133 |
| Mailing Telephone | 4023727375 |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2019-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
P-1585 | NE | Behavioral Health & Social Service Providers |
| Street Address |
401 S 39TH ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68131-3710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626086 | Spring Forward Ot, LLC | Occupational Therapist | 429 N. 38th Ave, Omaha, NE 68131 | 2020-03-31 |
| 1568944528 | Amy Vodicka | Case Manager/Care Coordinator | 3612 Cuming St., Omaha, NE 68131 | 2018-09-05 |
| 1982121919 | Lakeisha Marie Phelps | Peer Specialist | 3568 Dodge St, Omaha, NE 68131 | 2017-08-30 |
| 1063939098 | William L. Rolfe | Community Health Worker | 3568 Dodge Street, Suite 2, Omaha, NE 68131 | 2017-08-30 |
| 1578086294 | Nebraska Family Support Network | Community/Behavioral Health | 3568 Dodge St Ste 2, Omaha, NE 68131 | 2017-07-25 |
| 1124558937 | Beverly Hamilton | Case Manager/Care Coordinator | 3612 Cuming, Omaha, NE 68131 | 2017-06-14 |
| 1396291068 | Elizabeth George | Internal Medicine | 601 N. 30th St. Cu Department of Internal Medicine, Omaha, NE 68131 | 2016-08-31 |
| 1639625999 | Samuel Ramon Brown | Surgery | 601 N. 30th St. Cu Department of Surgery, Omaha, NE 68131 | 2016-08-28 |
| 1205289238 | Srilakshmi Reddy | Surgery | 601 N 30th St -cu Department of General Surgery, Omaha, NE 68131 | 2016-07-14 |
| 1881069409 | Jordan Sieh | Behavioral Analyst | 444 S. 44th St, Omaha, NE 68131 | 2015-12-08 |
| Find all providers in zip 68131 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930386 | Harry D Washington IIi | Counselor | 1299 Farnam, Omaha, NE 68105-6811 | 2020-07-23 |
| 1003432386 | Judi Scott | Counselor | 9733 Grant St, Omaha, NE 68134-5619 | 2020-06-22 |
| 1508481086 | William Sean Mcneil | Counselor | 3128 N 168th Ave, Omaha, NE 68116-2614 | 2020-06-10 |
| 1063048114 | Tiffany Gormley | Counselor | 18047 Oak St, Omaha, NE 68130-6093 | 2020-03-20 |
| 1851939565 | Mat Lavern Zollicoffer | Counselor | 1502 N 58th St, Omaha, NE 68104-4820 | 2019-12-12 |
| 1184269235 | Gary Darryl Mosley Sr. | Counselor | Tamarak Building Suite 101 G, 3035 Harney Street, Omaha, NE 68131-3500 | 2019-11-13 |
| 1437792439 | Lisa Ann Osler | Counselor | 1301 S 31st St Apt 15, Omaha, NE 68105-2048 | 2019-10-22 |
| 1154970176 | Loren Dexter | Counselor | 13808 U St, Omaha, NE 68137-2904 | 2019-09-11 |
| 1356908735 | David Brinkerhoff Ballard IIi | Counselor | 902 N 95th Plz Apt 5, Omaha, NE 68114-2561 | 2019-05-21 |
| 1881152189 | Dawn D Cornelius | Counselor | 1941 S 42nd St Ste 106, Omaha, NE 68105-2942 | 2019-03-05 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.