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General NPI Number Information
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NPI Number | 1548937717
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Entity Type | Individual
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Provider Name | ROSS JOHN RAUSCH PLMHP
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Gender | Male
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 6601 PIONEERS BLVD STE 1
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City | LINCOLN
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State | NE
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Zip | 68506-5260
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Country | US
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Telephone | 402-434-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 6540 TANGLEWOOD LN
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City | LINCOLN
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State | NE
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Zip | 68516-2356
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Country | US
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Telephone | 402-202-8940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12727
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License Number State | NE
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