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General NPI Number Information
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NPI Number | 1164446605
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Entity Type | Individual
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Provider Name | LELAND CARL ZLOMKE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 110 N 9TH ST
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City | BEATRICE
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State | NE
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Zip | 68310-4009
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Country | US
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Telephone | 402-483-6990
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Fax | 402-483-7045
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Provider Business Mailing Address
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Address Line | 5321 S 78TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-6356
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Country | US
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Telephone | 402-806-1700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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Taxonomy #3
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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Taxonomy #6
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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