Provider Demographics
NPI:1194363432
Name:ORENDA PSYCHOTHERAPY
Entity Type:Organization
Organization Name:ORENDA PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER, CLINICAL
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPER
Authorized Official - Suffix:
Authorized Official - Credentials:PCMSW, PLMHP
Authorized Official - Phone:402-910-0479
Mailing Address - Street 1:2921 N 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-2713
Mailing Address - Country:US
Mailing Address - Phone:402-910-0479
Mailing Address - Fax:
Practice Address - Street 1:4701 VAN DORN ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2511
Practice Address - Country:US
Practice Address - Phone:402-910-0479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty