Provider Demographics
NPI:1659794303
Name:SIKYTA, MARCELLA R
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:R
Last Name:SIKYTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 L ST
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862-1275
Mailing Address - Country:US
Mailing Address - Phone:308-728-4200
Mailing Address - Fax:
Practice Address - Street 1:110 S 26TH ST
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-1240
Practice Address - Country:US
Practice Address - Phone:308-728-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1174OtherMASTER SOCIAL WORKER
NE2933OtherLICENSED MENTAL HEALTH PRACTITIONER