Healthcare Provider Details

I. General information

NPI: 1356230809
Provider Name (Legal Business Name): SYDNEY BONGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11949 Q ST
OMAHA NE
68137-3503
US

IV. Provider business mailing address

117 S 38TH ST APT 1
OMAHA NE
68131-3174
US

V. Phone/Fax

Practice location:
  • Phone: 402-595-1326
  • Fax:
Mailing address:
  • Phone: 316-644-8595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14501
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14501
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: