Provider Demographics
NPI:1831657485
Name:ROKON, EMILY LYNN (LIMHP, LICSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNN
Last Name:ROKON
Suffix:
Gender:F
Credentials:LIMHP, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11404 W DODGE RD STE 600
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2593
Mailing Address - Country:US
Mailing Address - Phone:402-898-1113
Mailing Address - Fax:
Practice Address - Street 1:11404 W DODGE RD STE 600
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2593
Practice Address - Country:US
Practice Address - Phone:402-898-1113
Practice Address - Fax:402-819-5588
Is Sole Proprietor?:No
Enumeration Date:2019-03-02
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2519101YM0800X, 101YM0800X
NE116221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025339600Medicaid