Provider Demographics
NPI:1053707968
Name:RUBANGO, KANI-NSIMIRE (LMSW)
Entity type:Individual
Prefix:
First Name:KANI-NSIMIRE
Middle Name:
Last Name:RUBANGO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 HARNEY ST STE 714
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2314
Mailing Address - Country:US
Mailing Address - Phone:402-714-0762
Mailing Address - Fax:
Practice Address - Street 1:1905 HARNEY ST STE 714
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-2314
Practice Address - Country:US
Practice Address - Phone:402-714-0762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076681104100000X
NE18561041C0700X
NE17281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker