Provider Demographics
NPI:1245602051
Name:ZEGERS, RONNA (LICSW)
Entity Type:Individual
Prefix:
First Name:RONNA
Middle Name:
Last Name:ZEGERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 W DODGE RD STE 330C
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3413
Mailing Address - Country:US
Mailing Address - Phone:402-290-2861
Mailing Address - Fax:
Practice Address - Street 1:8420 W DODGE RD STE 330C
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3413
Practice Address - Country:US
Practice Address - Phone:402-290-2861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1101101YM0800X
NE14081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health