Provider Demographics
NPI:1902388051
Name:PLOHOCKY, JONATHAN (LADC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:PLOHOCKY
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 S BURLINGTON AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-6928
Mailing Address - Country:US
Mailing Address - Phone:402-462-2066
Mailing Address - Fax:402-462-2045
Practice Address - Street 1:835 S BURLINGTON AVE STE 115
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-6928
Practice Address - Country:US
Practice Address - Phone:402-462-2066
Practice Address - Fax:402-462-2045
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1237101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)