Provider Demographics
NPI:1003649195
Name:KREJDL, PAYTON MICHELLE (PLMHP, PLCSW)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:MICHELLE
Last Name:KREJDL
Suffix:
Gender:F
Credentials:PLMHP, PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5539 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-1648
Mailing Address - Country:US
Mailing Address - Phone:402-435-2811
Mailing Address - Fax:402-547-4186
Practice Address - Street 1:5539 S 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1648
Practice Address - Country:US
Practice Address - Phone:402-435-2811
Practice Address - Fax:402-547-4186
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14007101YM0800X
NE80591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health