Healthcare Provider Details

I. General information

NPI: 1346341799
Provider Name (Legal Business Name): MARY K. CAUDY LCSW, LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 S 16TH ST
LINCOLN NE
68502-3704
US

IV. Provider business mailing address

6100 ROLLING HILLS BLVD
LINCOLN NE
68512-1853
US

V. Phone/Fax

Practice location:
  • Phone: 402-481-5700
  • Fax: 402-481-9261
Mailing address:
  • Phone: 402-423-4551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number782
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number200
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: