Healthcare Provider Details

I. General information

NPI: 1770589962
Provider Name (Legal Business Name): LISA VOGEL MSED,ATR ,LIMHP,LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9105 BEDFORD AVE
OMAHA NE
68134-4723
US

IV. Provider business mailing address

9105 BEDFORD AVE
OMAHA NE
68134
US

V. Phone/Fax

Practice location:
  • Phone: 402-393-0133
  • Fax: 402-391-0498
Mailing address:
  • Phone: 402-393-0133
  • Fax: 402-391-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number89-182
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number43725
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number908
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1189
License Number StateNE
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00363
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1406
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: