Provider Demographics
NPI:1972688893
Name:DRAEGER, DOUGLAS O (LMHP)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:O
Last Name:DRAEGER
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2282 E 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-7233
Mailing Address - Country:US
Mailing Address - Phone:402-563-9224
Mailing Address - Fax:402-563-0544
Practice Address - Street 1:2282 E 32ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-7233
Practice Address - Country:US
Practice Address - Phone:402-563-9224
Practice Address - Fax:402-563-0544
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE84124OtherBLUE CROSS & BLUE SHIELD
NE10025079900Medicaid
NE229097OtherMIDLANDS CHOICE INS
NE229097OtherMIDLANDS CHOICE INS