Healthcare Provider Details

I. General information

NPI: 1356149702
Provider Name (Legal Business Name): AUSTIN L HANEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12667 N 161ST AVE
BENNINGTON NE
68007-5619
US

IV. Provider business mailing address

12667 N 161ST AVE
BENNINGTON NE
68007-5619
US

V. Phone/Fax

Practice location:
  • Phone: 402-320-5318
  • Fax: 402-320-5318
Mailing address:
  • Phone: 402-981-5602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: