Provider Demographics
NPI:1194808626
Name:MEIER, MARY LOU (LCSW, LMHP)
Entity type:Individual
Prefix:MS
First Name:MARY LOU
Middle Name:
Last Name:MEIER
Suffix:
Gender:F
Credentials:LCSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-1610
Mailing Address - Country:US
Mailing Address - Phone:402-432-0811
Mailing Address - Fax:
Practice Address - Street 1:4535 NORMAL BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5576
Practice Address - Country:US
Practice Address - Phone:402-434-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE7555OtherMIDLANDS CHOICE PROVIDER
NE82533OtherBCBS PROVIDER NUMBER
NE82533OtherBCBS PROVIDER NUMBER
NE0006330Medicare ID - Type UnspecifiedTRADING PARTNER NUMBER