Healthcare Provider Details

I. General information

NPI: 1548107337
Provider Name (Legal Business Name): BRANDY R ATHERTON LADC, CDGC,CPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3116 18TH ST STE 55
COLUMBUS NE
68601-4229
US

IV. Provider business mailing address

280 10TH AVE
COLUMBUS NE
68601-7866
US

V. Phone/Fax

Practice location:
  • Phone: 402-366-6771
  • Fax:
Mailing address:
  • Phone: 402-476-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1706
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: