Provider Demographics
NPI:1457407884
Name:WRAGGE, SUSAN E (MA, LMHP, CPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:WRAGGE
Suffix:
Gender:F
Credentials:MA, LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S 70TH ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3688
Mailing Address - Country:US
Mailing Address - Phone:402-486-1101
Mailing Address - Fax:402-486-1614
Practice Address - Street 1:2900 S 70TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3688
Practice Address - Country:US
Practice Address - Phone:402-486-1101
Practice Address - Fax:402-486-1614
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health