MEDICARE: LINCOLN BEHAVIORAL HEALTH CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1487688107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINCOLN BEHAVIORAL HEALTH CLINIC

Provider Business Mailing Address
First Line	:	3201 PIONEERS BLVD
Second Line	:	SUITE 202
City	:	LINCOLN
State	:	NE
Zip	:	68502-5963
Country	:	US
Telephone Number	:	402-489-9959
Fax Number	:	402-489-2219

Provider Business Practice Location Address
First Line	:	3201 PIONEERS BLVD
Second Line	:	SUITE 202
City	:	LINCOLN
State	:	NE
Zip	:	68502-5963
Country	:	US
Telephone Number	:	402-489-9959
Fax Number	:	402-489-2219

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUDY BYRNS
Credential	:	PH.D. LP
Telephone Number	:	402-489-9959

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/15/2014

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Practice Location Address:

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1306860184 — LYNN D MARCUS L.M.H.P.
Practice Location Address:

3201 PIONEERS BLVD , SUITE 202
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Practice Fax: 402-489-2219

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