Individual provider · Type 1 NPI

Mary Tyner

Mental Health Counselor · La Vista, NE

NPI number 1366053969 Active

Practice location

10748 Virginia Plz Ste 107
La Vista, NE 68128-3265

Call (402) 933-4411 Map

Fax (888) 507-5931

Mailing address

2205 Lucille Dr
Bellevue, NE 68147-2504

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician 106S00000XNone listed
Mental Health Counselor Primary 101YM0800X4463 (NE)

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About NPI 1366053969

Mary Tyner's National Provider Identifier is 1366053969, issued on Aug 17, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in La Vista, NE. The record was last updated on Mar 9, 2026.