Provider Demographics
NPI:1619601853
Name:FINNEGAN, BRENDA (PLADC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S 39TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-3710
Mailing Address - Country:US
Mailing Address - Phone:402-558-7088
Mailing Address - Fax:402-558-7133
Practice Address - Street 1:2052 DEER PARK BLVD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-1917
Practice Address - Country:US
Practice Address - Phone:402-558-7088
Practice Address - Fax:402-558-7133
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1975101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)