Provider Demographics
NPI:1144580937
Name:DIXIE R. PLACEK LLC
Entity Type:Organization
Organization Name:DIXIE R. PLACEK LLC
Other - Org Name:DIXIE MARESH PLACEK, RUTH ANN PLACEK, AFFILIATES IN FAMILY
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIXIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PLACEK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LIMHP, LIMFT
Authorized Official - Phone:402-826-2829
Mailing Address - Street 1:422 SOUTH BOSWELL AVENUE
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-3253
Mailing Address - Country:US
Mailing Address - Phone:402-826-2829
Mailing Address - Fax:402-826-2829
Practice Address - Street 1:422 SOUTH BOSWELL AVENUE
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-3253
Practice Address - Country:US
Practice Address - Phone:402-826-2829
Practice Address - Fax:402-826-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE601101YM0800X
NE045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty