Provider Demographics
NPI:1154146827
Name:TRIPP, CONTENNIA MARIE (PLADC)
Entity type:Individual
Prefix:MRS
First Name:CONTENNIA
Middle Name:MARIE
Last Name:TRIPP
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13156 D PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5318
Mailing Address - Country:US
Mailing Address - Phone:402-616-3672
Mailing Address - Fax:
Practice Address - Street 1:5620 AMES AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2702
Practice Address - Country:US
Practice Address - Phone:402-616-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP1949101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)