Provider Demographics
NPI:1497925192
Name:JONAS, AMY PATRICE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:PATRICE
Last Name:JONAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10832 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2672
Mailing Address - Country:US
Mailing Address - Phone:402-991-7441
Mailing Address - Fax:402-991-7445
Practice Address - Street 1:10832 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2672
Practice Address - Country:US
Practice Address - Phone:402-991-7441
Practice Address - Fax:402-991-7445
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2310101YM0800X
NE10191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health