MEDICARE: MS. LAURA M LENTZ MS LMHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1955	NE

General Provider Information

NPI Number	:	1003809914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA M LENTZ MS LMHP

Provider Business Mailing Address
First Line	:	17940 WELCH PLAZA #106
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135
Country	:	US
Telephone Number	:	402-881-0872
Fax Number	:

Provider Business Practice Location Address
First Line	:	17940 WELCH PLAZA #106
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135
Country	:	US
Telephone Number	:	402-881-0872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	01/08/2024

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