Provider Demographics
NPI:1669775722
Name:SLONECKER, JAMIE (LIMHP CPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SLONECKER
Suffix:
Gender:F
Credentials:LIMHP CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 N ERIE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-1504
Mailing Address - Country:US
Mailing Address - Phone:308-746-4293
Mailing Address - Fax:
Practice Address - Street 1:1201 N ERIE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850
Practice Address - Country:US
Practice Address - Phone:308-324-8322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2087101YM0800X
NE4287101YM0800X
NE1384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2087OtherNEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES- LICENSURE UNIT
NE1384OtherLICENSED INDEPENDENT MENTAL HEALTH PRACTITIONER
NE4287OtherNEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES- LICENSURE UNIT