ELICIA MARIE OMALLEY (NPI# 1801172432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801172432 |
| Entity Type | Individual |
| Full Name | ELICIA MARIE OMALLEY |
| Credential | LADC |
| Practice Address |
1911 Pleasant Avenue South Minneapolis MN 55403 |
| Practice Telephone | 6125960099 |
| Practice Fax Number | 7634754297 |
| Mailing Telephone | 6125960099 |
| Mailing Fax Number | 7634754297 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302540 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | LICENSED ALCOHOL AND DRUG COUNSELOR | 302540 | 01 |
| Street Address |
1911 PLEASANT AVENUE SOUTH |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508312174 | Afya Translation Corp | Interpreter | 1 E 19th Street, Suite 2, Minneapolis, MN 55403 | 2016-09-01 |
| 1891146692 | Alicia Kornacker | Doula | 1937 Aldrich Avenue South, Apt 12, Minneapolis, MN 55403 | 2016-06-23 |
| 1437506417 | Zahra Roble | Nurse Practitioner | 1801 Nicolllet Ave S, Minneapolis, MN 55403 | 2016-05-19 |
| 1063871259 | Vicky Smiley-turner | Counselor | 1523 Nicollet Ave. South, Minneapolis, MN 55403 | 2016-02-16 |
| 1326449026 | Lowry Hill Psychotherapy and Assessment Center | Psychologist | 1910 Hennepin Ave S, Minneapolis, MN 55403 | 2014-09-12 |
| 1285062372 | Cheryl Patterson | Marriage & Family Therapist | 1725 2nd Ave So, Minneapolis, MN 55403 | 2013-10-29 |
| 1598101156 | Sherri M Dunham | Counselor | 1200 S Marquette Ave, Minneapolis, MN 55403 | 2013-05-21 |
| 1831533173 | Laura Farley Young | Social Worker | 1925 Nicollet Ave S, Minneapolis, MN 55403 | 2013-04-17 |
| 1275801797 | Elizabeth Ann Hamer | Counselor | 1717/1725 2nd Ave. So., Minneapolis, MN 55403 | 2011-12-12 |
| 1679859185 | Accord Medical Inc | Durable Medical Equipment & Medical Supplies | 1815 Nicollet Ave, Minneapolis, MN 55403 | 2011-10-27 |
| Find all providers in zip 55403 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1366056392 | Brianna Connor | Counselor | 2450 Riverside Ave Bldg Suite140, Minneapolis, MN 55454-1450 | 2020-09-08 |
| 1144831959 | Brian James Rose | Counselor | 5061 Lyndale Ave S, Minneapolis, MN 55419-1215 | 2020-08-14 |
| 1740891688 | Jennifer Twa | Counselor | 2104 Stevens Ave, Minneapolis, MN 55404-2533 | 2020-08-13 |
| 1568072254 | Marian Margaret Spiess | Counselor | 2200 1st Ave S, Minneapolis, MN 55404-3401 | 2020-08-06 |
| 1689201352 | Alyssa Mary Nyberg | Counselor | 2960 Winnetka Ave N Ste 1010, Minneapolis, MN 55427-2853 | 2020-03-24 |
| 1497392666 | Kristine Geraldine Hanson | Counselor | 2611 40th Ave S, Minneapolis, MN 55406-1862 | 2019-12-05 |
| 1265080501 | Carolyn J Niesche | Counselor | 2518 N 2nd St Ste 113, Minneapolis, MN 55411-2259 | 2019-08-29 |
| 1053966069 | Shane Jensen | Counselor | 610 22nd Ave S, Minneapolis, MN 55454-1315 | 2019-08-06 |
| 1114584760 | Lynn Marie Allar | Counselor | 2200 E Franklin Ave Ste 200a, Minneapolis, MN 55404-2395 | 2019-05-20 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55403 |
Please comment or provide details below to improve the information on ELICIA MARIE OMALLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.