Healthcare Provider Details

I. General information

NPI: 1881772721
Provider Name (Legal Business Name): MARY LOU BUSS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 O ST SUITE 304
LINCOLN NE
68510-2468
US

IV. Provider business mailing address

7910 O ST
LINCOLN NE
68510-2500
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-5600
  • Fax: 402-484-5630
Mailing address:
  • Phone: 402-489-5339
  • Fax: 402-489-7366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1375
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number472
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: