Basic Information
| Provider Information | |||||||||
| NPI: | 1689008237 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | MANETTE | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2201 S 17TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685023713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024417940 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2201 S 17TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685023713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024417940 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2013 | ||||||||
| LastUpdateDate: | 08/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 10062 | NE | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | 57 | NE | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.