Individual
MRS. MADONNA MARIA LICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LMHP
Contact information
Practice address
1490 NO 16TH ST, OMAHA, NE 68102
(402) 827-0570
(402) 827-0580
Mailing address
3300 NO 60TH ST, OMAHA, NE 68104
(402) 554-0520
(402) 551-8797
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
805
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47037661286
—
NE
Enumeration date
01/02/2007
Last updated
07/08/2007
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