Provider Demographics
NPI:1376760652
Name:PICK, ROBERT (LMHP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:PICK
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13603 FLANAGAN BLVD
Mailing Address - Street 2:YOUTH CARE BUILDING
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-7501
Mailing Address - Country:US
Mailing Address - Phone:402-498-3358
Mailing Address - Fax:402-498-3333
Practice Address - Street 1:13603 FLANAGAN BLVD
Practice Address - Street 2:YOUTH CARE BUILDING
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7501
Practice Address - Country:US
Practice Address - Phone:402-498-3358
Practice Address - Fax:402-498-3333
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47037660631Medicaid