Provider Demographics
NPI:1306026943
Name:FOLCIK, LYNN ACQUAVITA (MS)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ACQUAVITA
Last Name:FOLCIK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 N HASTINGS AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5169
Mailing Address - Country:US
Mailing Address - Phone:402-462-9400
Mailing Address - Fax:
Practice Address - Street 1:422 N HASTINGS AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5169
Practice Address - Country:US
Practice Address - Phone:402-462-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE259101YA0400X
NE1407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health