Provider Demographics
NPI:1922658822
Name:HAGER, RANDALL (LMHP, NCC)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:
Last Name:HAGER
Suffix:
Gender:M
Credentials:LMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 461004
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-1004
Mailing Address - Country:US
Mailing Address - Phone:402-213-0244
Mailing Address - Fax:402-702-1540
Practice Address - Street 1:8790 F ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1524
Practice Address - Country:US
Practice Address - Phone:402-213-0244
Practice Address - Fax:402-702-1540
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5952101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health