Healthcare Provider Details

I. General information

NPI: 1548658313
Provider Name (Legal Business Name): ORR PSYCHOTHERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 S 59TH ST SUITE 104
LINCOLN NE
68516-2386
US

IV. Provider business mailing address

5600 S 59TH ST SUITE 104
LINCOLN NE
68516-2386
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-0595
  • Fax: 402-484-6306
Mailing address:
  • Phone: 402-484-0595
  • Fax: 402-484-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN LONERGAN-ORR
Title or Position: BUSINESS MANAGER
Credential:
Phone: 402-484-0595