=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043538325
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RICHARD ANDREW BUSS, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2010
-----------------------------------------------------
Last Update Date | 10/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7257 ANDY DR
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-1021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-853-2396
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7257 ANDY DR
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-1021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-853-2396
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RICHARD ANDREW BUSS
-----------------------------------------------------
Credential | M.S. ED., L.I.M.H.P.
-----------------------------------------------------
Telephone | 402-853-2396
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 1812
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------