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Individual

GINA LYNN MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLMHP, PLCSW

Contact information

Practice address
9239 W CENTER RD STE 201, OMAHA, NE 68124-1900
(402) 354-8005
(402) 354-8046
Mailing address
12512 SPENCER ST, OMAHA, NE 68164-5209
(402) 212-2978

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13824
NE
1041C0700X
Clinical Social Worker
8000
NE

Other

Enumeration date
07/29/2024
Last updated
07/29/2024
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