Provider Demographics
NPI:1093990145
Name:WRAGGE, MARCIA A (MS, MSW, LMHP)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:A
Last Name:WRAGGE
Suffix:
Gender:F
Credentials:MS, MSW, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11905 ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2970
Mailing Address - Country:US
Mailing Address - Phone:402-383-5974
Mailing Address - Fax:
Practice Address - Street 1:11905 ARBOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2970
Practice Address - Country:US
Practice Address - Phone:402-330-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2022-01-31
Deactivation Date:2021-12-28
Deactivation Code:
Reactivation Date:2022-01-11
Provider Licenses
StateLicense IDTaxonomies
NE961101YM0800X
NE2102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health