Individual provider Active NPI

Peggy Ann Bonacci, LMHP, LCSW

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1922645027
Registry record updated Dec 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
975 Issued in NE
Practice address
8031 W Center Rd Ste 324
Omaha, NE 68124-3149
Phone
(531) 800-7117
NPI assigned
Dec 8, 2019
Last updated
Dec 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2019

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 2147 NE
Clinical Social Worker 1041C0700X 975 NE Primary

Addresses

Primary practice location

8031 W Center Rd Ste 324
Omaha, NE 68124-3149

Mailing address

1626 S 98TH St
Omaha, NE 68124-1148
Phone (402) 507-7816

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
I20201022000575 NE Practitioner - Clinical Social Worker 5698195162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Nebraska College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8031 W Ctr Rd
Suite 324
Omaha, NE 68124-3149
Phone (531) 800-7117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
975NEMDClinical Psychologist
2147NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peggy Bonacci Counseling LLC Clinical CurrentSince Oct 1, 2020 Accepting new patients

Locations

8031 W Center Rd
Ste 324
Omaha, NE 68124
Phone (402) 537-9628

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1575763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575763200000",
    "number": "1922645027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 S 98TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241148",
            "telephone_number": "402-507-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 W CENTER RD STE 324",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243149",
            "telephone_number": "531-800-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONACCI",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMHP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-08",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2147",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.