Healthcare Provider Details

I. General information

NPI: 1275668535
Provider Name (Legal Business Name): LINCOLN LANCASTER COUNTY CHILD ADVOCACY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SUMNER STREET
LINCOLN NE
68502
US

IV. Provider business mailing address

3200 SUMNER STREET
LINCOLN NE
68502
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-3200
  • Fax: 402-476-5330
Mailing address:
  • Phone: 402-476-3200
  • Fax: 402-476-5330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LYNN ELLEN AYERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 402-476-3200