Provider Demographics
NPI:1427315175
Name:GIESEKE, MARY L (LIMHP LADC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:GIESEKE
Suffix:
Gender:F
Credentials:LIMHP LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 CALUMET CT
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-4116
Mailing Address - Country:US
Mailing Address - Phone:402-730-6859
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1510 Q ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1647
Practice Address - Country:US
Practice Address - Phone:402-730-6859
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1065101YA0400X
NEP-9625101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)