Provider Demographics
NPI:1902016546
Name:KINCS, PAUL K (M A)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:K
Last Name:KINCS
Suffix:
Gender:M
Credentials:M A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 SOUTH 86TH STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526
Mailing Address - Country:US
Mailing Address - Phone:402-483-6990
Mailing Address - Fax:402-483-7045
Practice Address - Street 1:4545 S 86TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9227
Practice Address - Country:US
Practice Address - Phone:402-483-6990
Practice Address - Fax:402-483-7045
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3213101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470798717-26Medicaid
NE470798717-27Medicaid
NE470798717-27Medicaid