Provider Demographics
NPI:1427108646
Name:LILJEHORN, TINA MARIE (LMHP LCSW)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:LILJEHORN
Suffix:
Gender:F
Credentials:LMHP LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 W APRICOT LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-4423
Mailing Address - Country:US
Mailing Address - Phone:402-499-8793
Mailing Address - Fax:
Practice Address - Street 1:1240 N 10TH ST STE 2
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1125
Practice Address - Country:US
Practice Address - Phone:402-747-1412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6547PLCSW1041C0700X
NE3559101YM0800X
NE8209PLMHP101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical