Provider Demographics
NPI:1477995033
Name:RONEY, MARISSA (LMHP, PLADC)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:RONEY
Suffix:
Gender:F
Credentials:LMHP, PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 S 145TH ST
Mailing Address - Street 2:APARTMENT 26
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6924
Mailing Address - Country:US
Mailing Address - Phone:402-415-8035
Mailing Address - Fax:
Practice Address - Street 1:11713 M CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2218
Practice Address - Country:US
Practice Address - Phone:402-933-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10026101YM0800X
NE4578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health