Provider Demographics
NPI:1427004712
Name:BASKIN, MARIANNE (CMSW, LMHP)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:BASKIN
Suffix:
Gender:F
Credentials:CMSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 B ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-1640
Mailing Address - Country:US
Mailing Address - Phone:402-202-4916
Mailing Address - Fax:402-475-4643
Practice Address - Street 1:2120 S 56TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2118
Practice Address - Country:US
Practice Address - Phone:402-202-4916
Practice Address - Fax:402-475-4643
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00018900OtherRAILROAD MEDICARE PROV #
P00018900OtherRAILROAD MEDICARE PROV #
NE274328Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER