Healthcare Provider Details

I. General information

NPI: 1033702592
Provider Name (Legal Business Name): TIKISHA CUEVAS PLMHP, PLADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W PASEWALK AVE STE A
NORFOLK NE
68701-5657
US

IV. Provider business mailing address

1800 W PASEWALK AVE STE A
NORFOLK NE
68701-5657
US

V. Phone/Fax

Practice location:
  • Phone: 402-500-6870
  • Fax:
Mailing address:
  • Phone: 402-500-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP-2051
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14703
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: