Provider Demographics
NPI:1174774640
Name:CARMICHAEL, LEANNA RENEE (LIMHP)
Entity type:Individual
Prefix:MRS
First Name:LEANNA
Middle Name:RENEE
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:MRS
Other - First Name:LEANNA
Other - Middle Name:RENEE
Other - Last Name:KARRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LOU CARMICHAEL
Mailing Address - Street 1:3883 NORMAL BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5218
Mailing Address - Country:US
Mailing Address - Phone:314-517-5733
Mailing Address - Fax:
Practice Address - Street 1:3883 NORMAL BLVD STE 204
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5218
Practice Address - Country:US
Practice Address - Phone:314-517-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NE3385101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health