Provider Demographics
NPI:1164446605
Name:ZLOMKE, LELAND CARL (PHD)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:CARL
Last Name:ZLOMKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 S 78TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6356
Mailing Address - Country:US
Mailing Address - Phone:402-806-1700
Mailing Address - Fax:
Practice Address - Street 1:110 N 9TH ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-4009
Practice Address - Country:US
Practice Address - Phone:402-483-6990
Practice Address - Fax:402-483-7045
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE245672OtherMIDLANDS CHOICE
NEP00963834OtherMEDICARE RAILROAD
NE49038OtherBCBS
NE90095OtherBCBS AUXILLARY
NE90095OtherBCBS AUXILLARY
NE10026091000Medicaid
NE245672OtherMIDLANDS CHOICE
NE49038OtherBCBS
NENA1972002Medicare PIN