Provider Demographics
NPI:1326504267
Name:MOHLFELD, KATHY I (LCSW, EDD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:I
Last Name:MOHLFELD
Suffix:
Gender:F
Credentials:LCSW, EDD
Other - Prefix:DR
Other - First Name:KATHY
Other - Middle Name:I
Other - Last Name:MOHLFELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, EDD
Mailing Address - Street 1:1200 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1299
Mailing Address - Country:US
Mailing Address - Phone:402-375-3800
Mailing Address - Fax:402-375-7988
Practice Address - Street 1:1200 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1299
Practice Address - Country:US
Practice Address - Phone:402-375-3800
Practice Address - Fax:402-375-7988
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1881101YM0800X
NE8931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health