Maddalena, Kelly A

Maddalena, Kelly A is an sole proprietor health care provider with primary practice located at 15106 Spencer St , Omaha NE 68116-8106. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Maddalena, Kelly A can be contacted via phone (402) 594-4911.

Contact Information

Primary practice address
15106 Spencer St Omaha NE 68116-8106
Phone: (402) 594-4911
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 509 Nebraska
Behavioral Health & Social Service Providers / Social Worker 104100000X 1006 Nebraska
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1006 Nebraska

Profile Details

NPI number 1093709164
LBN Legal business name Maddalena, Kelly A
Credentials LCSW, LMHP, LIMHP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2005
Last updated Nov 1st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093709164 NPPES
Other 85120 BCBS

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