Individual provider Active NPI

Marcia A Wragge, MS, MSW, LMHP

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1093990145
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2102 Issued in NE
Practice address
11905 Arbor St
Omaha, NE 68144-2970
Phone
(402) 330-8850
NPI assigned
Jan 8, 2008
Reactivated
Jan 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 961 NE
Mental Health Counselor 101YM0800X 2102 NE Primary

Addresses

Primary practice location

11905 Arbor St
Omaha, NE 68144-2970

Mailing address

11905 Arbor St
Omaha, NE 68144-2970
Phone (402) 383-5974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110517000135 NE Practitioner - Clinical Social Worker 5991981508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1045 N 115TH St
Suite 205
Omaha, NE 68154-4422
Phone (402) 383-5974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2102NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wragge Psychotherapy Inc Mental Health CurrentSince Mar 7, 2001 Accepting new patients
Great Plains Mental Health Associates LLC Mental Health CurrentSince Apr 1, 2019 Accepting new patients
Wragge Psychotherapy Inc Current Accepting new patients
Valley Roots Family Care PLLC PastSince Jan 1, 2016 Accepting new patients
Cascade Neuropsychology, PLLC PastSince Jun 10, 2024 Accepting new patients

Locations

4610 S 133rd St
Ste 109
Omaha, NE 68137
Phone (402) 614-0010

11905 Arbor St
Omaha, NE 68144
Phone (402) 330-4456

1045 N 115th St
Ste 205
Omaha, NE 68154
Phone (402) 383-5974

11725 Arbor St
Ste 310
Omaha, NE 68144
Phone (402) 819-9079

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21060/brand/4/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1093990145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 ARBOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442970",
            "telephone_number": "402-383-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 ARBOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442970",
            "telephone_number": "402-330-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAGGE",
        "first_name": "MARCIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MS, MSW, LMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "deactivation_date": "2021-12-28",
        "reactivation_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "961",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.