Provider Demographics
NPI:1366769465
Name:MCDONNELL, ROBYN (MS, NCC, LIMHP, CPC)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:MS, NCC, LIMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 DODGE ST
Mailing Address - Street 2:SUITE #301
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2906
Mailing Address - Country:US
Mailing Address - Phone:402-342-3303
Mailing Address - Fax:402-408-9736
Practice Address - Street 1:5002 DODGE ST
Practice Address - Street 2:SUITE #301
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-2906
Practice Address - Country:US
Practice Address - Phone:402-342-3303
Practice Address - Fax:402-408-9736
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE614101YM0800X
NE1137101YP2500X
NE1981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39197610626Medicaid