Provider Demographics
NPI:1023565108
Name:MASEK, AMY LYNN (PLMHP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:MASEK
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E 2ND ST STE 10
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5474
Mailing Address - Country:US
Mailing Address - Phone:308-221-6902
Mailing Address - Fax:308-221-6904
Practice Address - Street 1:109 E 2ND ST STE 10
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5474
Practice Address - Country:US
Practice Address - Phone:308-221-6902
Practice Address - Fax:308-221-6904
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health