Provider Demographics
NPI:1306587944
Name:LAWRENCE, BRITTANY RAE (MA, PLMHP, NCC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RAE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MA, PLMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 COUNTY ROAD H
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NE
Mailing Address - Zip Code:68033-2236
Mailing Address - Country:US
Mailing Address - Phone:308-520-6829
Mailing Address - Fax:
Practice Address - Street 1:4565 S 133RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1142
Practice Address - Country:US
Practice Address - Phone:402-590-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health