Provider Demographics
NPI:1427116060
Name:SALAYCIK, STEPHEN ANTHONY (MS)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:SALAYCIK
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 GOLD COAST RD
Mailing Address - Street 2:#10
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2864
Mailing Address - Country:US
Mailing Address - Phone:402-592-1911
Mailing Address - Fax:
Practice Address - Street 1:5625 O STREET
Practice Address - Street 2:SUITE 7
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2198
Practice Address - Country:US
Practice Address - Phone:402-489-8484
Practice Address - Fax:402-441-0664
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE394101YM0800X
NE878104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47076770226Medicaid
NE47076770268510B002OtherTRICARE TRIWEST
NE47076770268510A001OtherTRICARE
NE47076770226Medicaid