Provider Demographics
NPI:1760568067
Name:ZINK-WYTHERS, JEANIE (MA, LMHP, LADC)
Entity Type:Individual
Prefix:MS
First Name:JEANIE
Middle Name:
Last Name:ZINK-WYTHERS
Suffix:
Gender:F
Credentials:MA, LMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 ROAD I
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68354-4049
Mailing Address - Country:US
Mailing Address - Phone:402-759-2285
Mailing Address - Fax:
Practice Address - Street 1:1320 G ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-2104
Practice Address - Country:US
Practice Address - Phone:402-759-2285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE254101YA0400X
NE736101YP2500X
NE565101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE62-89529OtherUNITED HEALTHCARE SERVICE
NE100251239-00Medicaid
NE8355OtherMIDLANDS CHOICE
NE85194OtherBCBS
NE187876OtherMAGELLAN HEALTH SERVICES