Provider Demographics
NPI:1497524268
Name:DUGGIRALA, SRIHARSHA (PLMHP)
Entity type:Individual
Prefix:
First Name:SRIHARSHA
Middle Name:
Last Name:DUGGIRALA
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11605 MIRACLE HILLS DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4467
Mailing Address - Country:US
Mailing Address - Phone:402-238-1431
Mailing Address - Fax:402-281-1862
Practice Address - Street 1:11605 MIRACLE HILLS DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4467
Practice Address - Country:US
Practice Address - Phone:402-238-1431
Practice Address - Fax:402-281-1862
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10028891100Medicaid