Individual
MARY PATRICIA HASKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMHP, LADC
Contact information
Practice address
1627 E MILITARY AVE, SUITE 200, FREMONT, NE 68025-5490
(402) 727-4886
(402) 727-4146
Mailing address
1627 E MILITARY AVE, SUITE 200, FREMONT, NE 68025-5490
(402) 727-4886
(402) 727-4146
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
855
NE
101YM0800X
Mental Health Counselor
3724
NE
1041C0700X
Clinical Social Worker
Primary
1369
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025687100
—
NE
01
—
NA1687
MEDICARE PTAN
NE
Enumeration date
05/07/2008
Last updated
12/02/2013
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