Gerald Lou Mayo III, MSW, PLMHP
Counselor, Mental Health in South Sioux City, NE. Individual provider (NPI-1).
NPI number1124375563
StatusActive
Last updated in NPPESFeb 18, 2014
Details
- NPI
- 1124375563
- Entity type
- Individual (NPI-1)
- Name
- Mr. Gerald Lou Mayo III
- Credential
- MSW, PLMHP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 3, 2012
- Last updated
- Feb 18, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 9719 | NE | Yes |
| 1041C0700X | Social Worker, Clinical | 6822 | NE |
Practice location
917 W 21st StSouth Sioux City, NE 68776-2652
Phone 402-494-3337 · Fax 402-494-3356
Mailing address
917 W 21st StP.O. Box 355
South Sioux City, NE 68776-2652
Phone 402-494-3337 · Fax 402-494-3356
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