Provider Demographics
NPI:1184775561
Name:STEVENS, RONDA L (MSW)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 S 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2011
Mailing Address - Country:US
Mailing Address - Phone:402-334-3569
Mailing Address - Fax:
Practice Address - Street 1:7602 PACIFIC ST STE 305
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-5405
Practice Address - Country:US
Practice Address - Phone:402-393-8277
Practice Address - Fax:402-393-3609
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical