Provider Demographics
NPI:1730477563
Name:WRAGGE PSYCHOTHERAPY INC
Entity Type:Organization
Organization Name:WRAGGE PSYCHOTHERAPY INC
Other - Org Name:MARCIA A. WRAGGE, MS. LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WRAGGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MSW
Authorized Official - Phone:402-383-5974
Mailing Address - Street 1:11905 ARBOR ST STE 310
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2970
Mailing Address - Country:US
Mailing Address - Phone:402-383-5974
Mailing Address - Fax:
Practice Address - Street 1:11905 ARBOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2970
Practice Address - Country:US
Practice Address - Phone:402-383-5974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherBLUE CROSS