Healthcare Provider Details

I. General information

NPI: 1922425701
Provider Name (Legal Business Name): KRISSI K WRENN LMHP, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRIS K WRENN LMHP, LCSW

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2534 A ST
LINCOLN NE
68502-1838
US

IV. Provider business mailing address

4915 W MCGUIRE RD
LINCOLN NE
68524-1146
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-6759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number481
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number544
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: