Provider Demographics
NPI:1033101183
Name:LENZEN, TERESA M (LIMHP)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:LENZEN
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11510 BLONDO ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-3836
Mailing Address - Country:US
Mailing Address - Phone:402-403-0190
Mailing Address - Fax:402-932-4121
Practice Address - Street 1:11510 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3836
Practice Address - Country:US
Practice Address - Phone:402-403-0190
Practice Address - Fax:402-932-4121
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NELIMHP - 546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health