Provider Demographics
NPI:1801847686
Name:SLOMINSKI, MARY K (LCMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:K
Last Name:SLOMINSKI
Suffix:
Gender:F
Credentials:LCMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1226
Mailing Address - Country:US
Mailing Address - Phone:402-978-5656
Mailing Address - Fax:402-591-5075
Practice Address - Street 1:1201 GOLDEN GATE DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2837
Practice Address - Country:US
Practice Address - Phone:402-592-0639
Practice Address - Fax:402-592-0014
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE23726797209Medicaid
NE23726797209Medicaid