Provider Demographics
NPI:1669648911
Name:UCHEAGWU, GREGORY OJIEWULU (MA, MHR)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:OJIEWULU
Last Name:UCHEAGWU
Suffix:
Gender:M
Credentials:MA, MHR
Other - Prefix:
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Mailing Address - Street 1:6818 GROVER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3640
Mailing Address - Country:US
Mailing Address - Phone:402-556-1153
Mailing Address - Fax:402-556-1153
Practice Address - Street 1:6818 GROVER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3640
Practice Address - Country:US
Practice Address - Phone:402-556-1153
Practice Address - Fax:402-556-1153
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE2173101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084629926Medicaid