Provider Demographics
NPI:1285095067
Name:SLEPICKA, IVY ROSE (LIMHP)
Entity type:Individual
Prefix:
First Name:IVY
Middle Name:ROSE
Last Name:SLEPICKA
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7905 L ST STE 430
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1732
Mailing Address - Country:US
Mailing Address - Phone:402-765-8133
Mailing Address - Fax:
Practice Address - Street 1:11905 P ST STE 105
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2237
Practice Address - Country:US
Practice Address - Phone:402-765-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5255101YM0800X
NE3857101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health