Provider Demographics
NPI:1902198690
Name:BYKERK, TERI ANN (LADC)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:ANN
Last Name:BYKERK
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 S KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-7024
Mailing Address - Country:US
Mailing Address - Phone:402-462-4677
Mailing Address - Fax:402-462-4699
Practice Address - Street 1:907 S KANSAS AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-7024
Practice Address - Country:US
Practice Address - Phone:402-462-4677
Practice Address - Fax:402-462-4699
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE427101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)