Provider Demographics
NPI:1568446318
Name:LEAMON, MANDY R (LMHP CMSW LIMHP LADC)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:R
Last Name:LEAMON
Suffix:
Gender:F
Credentials:LMHP CMSW LIMHP LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-398-6248
Mailing Address - Fax:402-829-8513
Practice Address - Street 1:7909 N 30TH STREET
Practice Address - Street 2:CHI HEALTH CLINIC FLORENCE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:402-717-0380
Practice Address - Fax:402-717-6059
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE725101YA0400X
NE2886101YM0800X
NE310101YM0800X
NE1159104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker