Healthcare Provider Details
I. General information
NPI: 1346896545
Provider Name (Legal Business Name): AUTISM SPECTRUM SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2019
Last Update Date: 04/27/2024
Certification Date: 04/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1560 S 70TH ST
LINCOLN NE
68506-1577
US
IV. Provider business mailing address
1560 S 70TH ST
LINCOLN NE
68506-1577
US
V. Phone/Fax
- Phone: 402-318-3105
- Fax:
- Phone: 402-318-3105
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDSAY
ANN
STANLEY
Title or Position: OWNER
Credential: BCBA, LMHP
Phone: 402-318-3105