Provider Demographics
NPI:1265912653
Name:OAKESON, MIKENSIE LEA (LIMHP, LADC)
Entity type:Individual
Prefix:
First Name:MIKENSIE
Middle Name:LEA
Last Name:OAKESON
Suffix:
Gender:F
Credentials:LIMHP, 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 108
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:402-463-7711
Mailing Address - Fax:402-461-5099
Practice Address - Street 1:835 S BURLINGTON AVE STE 108
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:402-463-7711
Practice Address - Fax:402-461-5099
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health