Provider Demographics
NPI:1285082305
Name:LEE, LAURA JO (OMSW, LMHP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JO
Last Name:LEE
Suffix:
Gender:F
Credentials:OMSW, LMHP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:JO
Other - Last Name:STEFFES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMSW, PLMHP
Mailing Address - Street 1:110 N BAILEY
Mailing Address - Street 2:P.O. BOX 1209
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69103-1209
Mailing Address - Country:US
Mailing Address - Phone:308-534-6029
Mailing Address - Fax:308-534-6961
Practice Address - Street 1:110 N BAILEY
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101
Practice Address - Country:US
Practice Address - Phone:308-534-6029
Practice Address - Fax:308-534-6961
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11118101YM0800X
171M00000X
NE5300101YM0800X
NE1833104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator