Provider Demographics
NPI:1871585919
Name:KUEHL, MARY LUCILLE (LMHP, CMSW, LADC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LUCILLE
Last Name:KUEHL
Suffix:
Gender:F
Credentials:LMHP, CMSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10826 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3134
Mailing Address - Country:US
Mailing Address - Phone:402-250-1128
Mailing Address - Fax:
Practice Address - Street 1:2101 S 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2947
Practice Address - Country:US
Practice Address - Phone:402-553-3000
Practice Address - Fax:402-552-7444
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NELADC 549101YA0400X
NELMHP 2614101YM0800X
NEMSW 10801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE277107Medicare UPIN