Provider Demographics
NPI:1548507767
Name:KINNEY, LAURA M (LMHP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:KINNEY
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4254 N 139TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-5015
Mailing Address - Country:US
Mailing Address - Phone:402-880-1683
Mailing Address - Fax:
Practice Address - Street 1:15705 W DODGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-2536
Practice Address - Country:US
Practice Address - Phone:531-444-1963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health