Provider Demographics
NPI:1932854437
Name:DOESCHER, EVANJELINA C (PLMHP,PCMSW)
Entity Type:Individual
Prefix:MRS
First Name:EVANJELINA
Middle Name:C
Last Name:DOESCHER
Suffix:
Gender:F
Credentials:PLMHP,PCMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S 42ND ST STE 402D
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2944
Mailing Address - Country:US
Mailing Address - Phone:402-788-4846
Mailing Address - Fax:402-702-0664
Practice Address - Street 1:1941 S 42ND ST STE 402D
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2944
Practice Address - Country:US
Practice Address - Phone:402-788-4846
Practice Address - Fax:402-702-0664
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7491104100000X
NE12244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker