Healthcare Provider Details

I. General information

NPI: 1306011705
Provider Name (Legal Business Name): WICKS PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 S 84TH ST SUITE 300
OMAHA NE
68127-4194
US

IV. Provider business mailing address

6550 S 84TH ST STE 300
OMAHA NE
68127-4100
US

V. Phone/Fax

Practice location:
  • Phone: 402-339-7991
  • Fax: 402-339-7624
Mailing address:
  • Phone: 402-339-7991
  • Fax: 402-339-7624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number216
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER G WICKS
Title or Position: OWNER
Credential: LCSW, LIMHP
Phone: 402-250-2482