Provider Demographics
NPI:1477726628
Name:MORALES, ALEJANDRO (PLMHP)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 KNOX STREET #8
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521
Mailing Address - Country:US
Mailing Address - Phone:402-488-6760
Mailing Address - Fax:402-489-2296
Practice Address - Street 1:1919 S 40TH ST STE 111
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5247
Practice Address - Country:US
Practice Address - Phone:402-488-6760
Practice Address - Fax:402-489-2296
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084440326Medicaid