Provider Demographics
NPI:1750863882
Name:KNEIFL, MINDY JANSSEN (PCMSW, PLMHP)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:JANSSEN
Last Name:KNEIFL
Suffix:
Gender:F
Credentials:PCMSW, PLMHP
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:NICOLE
Other - Last Name:JANSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCMSW, PLMHP
Mailing Address - Street 1:14905 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14905 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2512
Practice Address - Country:US
Practice Address - Phone:402-715-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE105611041S0200X
NE69881041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool