Individual
PATRICIA A COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W., L.M.H.P.
Contact information
Practice address
3201 PIONEERS BLVD, SUITE 202, LINCOLN, NE 68502-5963
(402) 489-9959
(402) 489-2219
Mailing address
3201 PIONEERS BLVD, SUITE 202, LINCOLN, NE 68502-5963
(402) 489-9959
(402) 489-2219
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1049
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232826
MIDLANDS CHOICE
NE
05
—
80003614126
—
NE
01
—
85613
BLUE CROSS BLUE SHIELD
NE
Enumeration date
07/15/2006
Last updated
07/08/2007
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