Provider Demographics
NPI:1437231628
Name:FRICKEL, ALICE MARIE (PLMHP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MARIE
Last Name:FRICKEL
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1027
Mailing Address - Country:US
Mailing Address - Phone:402-429-5660
Mailing Address - Fax:402-489-4765
Practice Address - Street 1:3720 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1027
Practice Address - Country:US
Practice Address - Phone:402-489-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026711000Medicaid