Provider Demographics
NPI:1407082647
Name:VONREIN, ANDREA M (PMHP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:VONREIN
Suffix:
Gender:F
Credentials:PMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9424 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-1520
Mailing Address - Country:US
Mailing Address - Phone:402-504-3653
Mailing Address - Fax:402-553-2428
Practice Address - Street 1:4545 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3232
Practice Address - Country:US
Practice Address - Phone:402-553-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8657101YM0800X
NE66371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical