Individual
MS. KELLY A MADDALENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMHP, LIMHP
Contact information
Practice address
15106 SPENCER ST, OMAHA, NE 68116-8106
(402) 594-4911
Mailing address
15106 SPENCER ST, OMAHA, NE 68116-8106
(402) 594-4911
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
509
NE
104100000X
Social Worker
1006
NE
1041C0700X
Clinical Social Worker
Primary
1006
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85120
BCBS
—
Enumeration date
09/06/2005
Last updated
11/01/2024
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