Provider Demographics
NPI:1437803756
Name:BROTT, REBECKA ANN (PLMHP, PCMSW)
Entity Type:Individual
Prefix:
First Name:REBECKA
Middle Name:ANN
Last Name:BROTT
Suffix:
Gender:F
Credentials:PLMHP, PCMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11605 MIRACLE HILLS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4467
Mailing Address - Country:US
Mailing Address - Phone:402-238-1431
Mailing Address - Fax:
Practice Address - Street 1:11605 MIRACLE HILLS DR STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4467
Practice Address - Country:US
Practice Address - Phone:402-238-1431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-06
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12891101YM0800X
NE7707104100000X
NE22971041C0700X
NE6039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical