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General NPI Number Information
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NPI Number | 1225789845
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Entity Type | Organization
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Legal Business Name | CUSICK PSYCHOTHERAPY, INCORPORATED
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 725 E 5TH ST
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City | FREMONT
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State | NE
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Zip | 68025-5163
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Country | US
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Telephone | 402-917-2570
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Fax | 402-941-7018
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Provider Business Mailing Address
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Address Line | 725 E 5TH ST
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City | FREMONT
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State | NE
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Zip | 68025-5163
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Country | US
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Telephone | 402-917-2570
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Fax | 402-941-7018
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Authorized Official
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Title or Position | OWNER ADMINISTRATOR
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Name | CYNTHIA JANE CUSICK
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Credential |
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Telephone | 402-917-2570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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