Provider Demographics
NPI:1720952708
Name:SWEITZER, KATHLEEN DANN'ELLE (PLADC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:DANN'ELLE
Last Name:SWEITZER
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 AURORA DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3329
Mailing Address - Country:US
Mailing Address - Phone:402-671-8591
Mailing Address - Fax:402-671-8591
Practice Address - Street 1:4505 AURORA DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3329
Practice Address - Country:US
Practice Address - Phone:402-671-8591
Practice Address - Fax:402-671-8591
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty