Provider Demographics
NPI:1033591441
Name:VONDERSCHMIDT, REBECCA (LADC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VONDERSCHMIDT
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355-2011
Mailing Address - Country:US
Mailing Address - Phone:402-245-4458
Mailing Address - Fax:402-245-4458
Practice Address - Street 1:103 E 35TH STE A
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355-1221
Practice Address - Country:US
Practice Address - Phone:402-245-4458
Practice Address - Fax:402-245-4459
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)