Provider Demographics
NPI:1720226806
Name:HOCK, CATHERINE (MS, LIMHP, NCC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:HOCK
Suffix:
Gender:F
Credentials:MS, LIMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 S 96TH ST STE 138
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1240
Mailing Address - Country:US
Mailing Address - Phone:402-819-9057
Mailing Address - Fax:
Practice Address - Street 1:4611 S 96TH ST STE 138
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1240
Practice Address - Country:US
Practice Address - Phone:402-819-9057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1114101Y00000X, 405300000X, 101YM0800X
NE2028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No405300000XOther Service ProvidersPrevention Professional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084125026Medicaid