Healthcare Provider Details

I. General information

NPI: 1679137962
Provider Name (Legal Business Name): ALEXIS MONAGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date: 01/15/2026
Reactivation Date: 03/13/2026

III. Provider practice location address

14710 W DODGE RD STE 200
OMAHA NE
68154-2027
US

IV. Provider business mailing address

8303 NICHOLAS ST
OMAHA NE
68114-2944
US

V. Phone/Fax

Practice location:
  • Phone: 402-709-8338
  • Fax:
Mailing address:
  • Phone: 402-686-9958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: