Healthcare Provider Details

I. General information

NPI: 1427368224
Provider Name (Legal Business Name): REBECCA KAY HENNING PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA KAY WIDOE PH.D.

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4428 S 162ND AVE
OMAHA NE
68135-1343
US

IV. Provider business mailing address

15418 WEIR ST # 142
OMAHA NE
68137-5045
US

V. Phone/Fax

Practice location:
  • Phone: 531-222-4147
  • Fax:
Mailing address:
  • Phone: 531-222-4147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number996
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number110602
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: