Healthcare Provider Details

I. General information

NPI: 1598224990
Provider Name (Legal Business Name): JESSICA LYNN LUTTRELL LCSW, LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 W 35TH ST
KEARNEY NE
68845-8017
US

IV. Provider business mailing address

124 W 46TH ST STE 207
KEARNEY NE
68847-8348
US

V. Phone/Fax

Practice location:
  • Phone: 308-698-8120
  • Fax:
Mailing address:
  • Phone: 402-205-5774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: