Provider Demographics
NPI:1144574609
Name:VICKI HOLOUBECK, INC
Entity Type:Organization
Organization Name:VICKI HOLOUBECK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLOUBECK
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-880-9453
Mailing Address - Street 1:1406 FORT CROOK RD S
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2992
Mailing Address - Country:US
Mailing Address - Phone:402-880-9453
Mailing Address - Fax:402-292-0144
Practice Address - Street 1:1406 FORT CROOK RD S
Practice Address - Street 2:SUITE 401
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2992
Practice Address - Country:US
Practice Address - Phone:402-880-9453
Practice Address - Fax:402-292-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty