Healthcare Provider Details

I. General information

NPI: 1285082305
Provider Name (Legal Business Name): LAURA JO LEE OMSW, LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA JO STEFFES PMSW, PLMHP

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N BAILEY
NORTH PLATTE NE
69101
US

IV. Provider business mailing address

110 N BAILEY P.O. BOX 1209
NORTH PLATTE NE
69103-1209
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-6029
  • Fax: 308-534-6961
Mailing address:
  • Phone: 308-534-6029
  • Fax: 308-534-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11118
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5300
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1833
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: