Provider Demographics
NPI:1164562617
Name:KRUSE, LINDSAY (LIMHP, LPC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:KRUSE
Suffix:
Gender:F
Credentials:LIMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 S 197TH CIR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-3777
Mailing Address - Country:US
Mailing Address - Phone:402-312-5315
Mailing Address - Fax:
Practice Address - Street 1:11510 BLONDO ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3846
Practice Address - Country:US
Practice Address - Phone:402-403-0190
Practice Address - Fax:402-932-4121
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3148101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE4737658526Medicaid
NEAUX98098OtherBLUECROSS BLUESHIELD