Provider Demographics
NPI:1417317744
Name:MARIYAPPAN, KARRAH K (LMHP)
Entity Type:Individual
Prefix:
First Name:KARRAH
Middle Name:K
Last Name:MARIYAPPAN
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N BURLINGTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5085
Mailing Address - Country:US
Mailing Address - Phone:402-834-0884
Mailing Address - Fax:888-972-3670
Practice Address - Street 1:303 N BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5085
Practice Address - Country:US
Practice Address - Phone:402-834-0884
Practice Address - Fax:888-972-3670
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10803101YM0800X
NE5060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE$$$$$$$$$01Medicaid