Provider Demographics
NPI:1740711746
Name:VICE, ALYSSA MARIE (LMHP, CMSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:VICE
Suffix:
Gender:F
Credentials:LMHP, CMSW
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:MARIE
Other - Last Name:STANKOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLMHP, CSW
Mailing Address - Street 1:13917 GOLD CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2359
Mailing Address - Country:US
Mailing Address - Phone:402-276-5860
Mailing Address - Fax:
Practice Address - Street 1:13917 GOLD CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2359
Practice Address - Country:US
Practice Address - Phone:402-276-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24281041C0700X
NE30771041C0700X
NE6200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical