Provider Demographics
NPI:1457506636
Name:VAKOC, AMARA C (MA, PLMHP)
Entity Type:Individual
Prefix:
First Name:AMARA
Middle Name:C
Last Name:VAKOC
Suffix:
Gender:F
Credentials:MA, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-1128
Mailing Address - Country:US
Mailing Address - Phone:402-437-8835
Mailing Address - Fax:402-434-0794
Practice Address - Street 1:1533 N 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-1128
Practice Address - Country:US
Practice Address - Phone:402-437-8835
Practice Address - Fax:402-434-0794
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health