Provider Demographics
NPI:1194085696
Name:MAPES, KATHLEEN L
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:L
Last Name:MAPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 I ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1222
Mailing Address - Country:US
Mailing Address - Phone:402-498-4700
Mailing Address - Fax:
Practice Address - Street 1:11550 I ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1222
Practice Address - Country:US
Practice Address - Phone:402-498-4700
Practice Address - Fax:402-493-3340
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2391101YP2500X
NE4774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional