Provider Demographics
NPI:1194570036
Name:PHELPS, LINDSEY K (LMHC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:K
Last Name:PHELPS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15928 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1958
Mailing Address - Country:US
Mailing Address - Phone:402-802-6709
Mailing Address - Fax:
Practice Address - Street 1:303 MCKENZIE AVE STE A
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-1014
Practice Address - Country:US
Practice Address - Phone:712-986-7800
Practice Address - Fax:712-986-7801
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health