Provider Demographics
NPI:1710767462
Name:SLADEK, ASIA L (PLMHP)
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:L
Last Name:SLADEK
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:ASIA
Other - Middle Name:
Other - Last Name:CAHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 N 115TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4419
Mailing Address - Country:US
Mailing Address - Phone:402-881-0074
Mailing Address - Fax:
Practice Address - Street 1:1055 N 115TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4419
Practice Address - Country:US
Practice Address - Phone:402-881-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty