Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1398 | NE |
Y | 101YM0800X | Mental Health Counselor | 5608 | NE |
NPI | 1003473588 |
---|---|
Provider Name | Jason Lemen |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-1023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2019 |
Last Update Date | 26/02/2021 |