Provider Demographics
NPI:1992015606
Name:COCOLAS, MELINDA R (LIMHP, LADC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:R
Last Name:COCOLAS
Suffix:
Gender:F
Credentials:LIMHP, LADC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:R
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3912 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-3442
Mailing Address - Country:US
Mailing Address - Phone:531-999-6429
Mailing Address - Fax:877-991-5647
Practice Address - Street 1:3912 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-3442
Practice Address - Country:US
Practice Address - Phone:531-999-6429
Practice Address - Fax:877-991-5647
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1282101YA0400X
NE2603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)