Provider Demographics
NPI:1093553828
Name:RACZYK, CATHERINE CAROL (PMHP, PMSW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:CAROL
Last Name:RACZYK
Suffix:
Gender:F
Credentials:PMHP, PMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13005 S 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2108
Mailing Address - Country:US
Mailing Address - Phone:224-636-6029
Mailing Address - Fax:
Practice Address - Street 1:4545 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3232
Practice Address - Country:US
Practice Address - Phone:402-553-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker