Provider Demographics
NPI:1790826634
Name:KLIMEK, JOYCE M (LSW, LMHP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:KLIMEK
Suffix:
Gender:F
Credentials:LSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 E 39TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-3445
Mailing Address - Country:US
Mailing Address - Phone:402-494-0040
Mailing Address - Fax:402-494-0050
Practice Address - Street 1:625 E 39TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3445
Practice Address - Country:US
Practice Address - Phone:402-494-0040
Practice Address - Fax:402-494-0050
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE74306484826Medicaid