Healthcare Provider Details

I. General information

NPI: 1679734008
Provider Name (Legal Business Name): ASHLEE SUE PRUIS-TRAPP PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY TRAPP

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 F ST
OMAHA NE
68117-2807
US

IV. Provider business mailing address

5115 F ST
OMAHA NE
68117-2807
US

V. Phone/Fax

Practice location:
  • Phone: 402-690-5091
  • Fax:
Mailing address:
  • Phone: 402-397-9866
  • Fax: 402-397-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14768
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPP.0001635
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: