Provider Demographics
NPI:1780640763
Name:RIZZO, JOSEPH L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:RIZZO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6818 GROVER ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3640
Mailing Address - Country:US
Mailing Address - Phone:402-397-0330
Mailing Address - Fax:402-397-8082
Practice Address - Street 1:6818 GROVER ST
Practice Address - Street 2:SUITE 303
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3640
Practice Address - Country:US
Practice Address - Phone:402-397-0330
Practice Address - Fax:402-397-8082
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE61-58868OtherUNITED BEHAVIOR HEALTH NU
NE022461OtherVALUE OPTIONS #
NE470608468-26Medicaid
NE117183-000OtherMAGELLAN MIS #
NE47-0608486OtherTRICARE PROVIDER #
NE08021OtherBCBS NUMBER
NE470608468-26Medicaid