Provider Demographics
NPI:1932402815
Name:MULCAHY, KATHLEEN RACHEL (LADC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RACHEL
Last Name:MULCAHY
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 L ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2228
Mailing Address - Country:US
Mailing Address - Phone:402-475-2694
Mailing Address - Fax:502-475-2699
Practice Address - Street 1:914 L ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2228
Practice Address - Country:US
Practice Address - Phone:402-475-2694
Practice Address - Fax:502-475-2699
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE796101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025221900Medicaid