Provider Demographics
NPI:1457058380
Name:DRAHOTA, ALICIA (PLADC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:DRAHOTA
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8998 L ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1400
Mailing Address - Country:US
Mailing Address - Phone:402-651-5404
Mailing Address - Fax:
Practice Address - Street 1:8998 L ST STE 110
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1400
Practice Address - Country:US
Practice Address - Phone:402-651-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2043101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)