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General NPI Number Information
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NPI Number | 1639321490
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Entity Type | Individual
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Provider Name | DUSTIN E BARTLEY LMHP, LADC, LPC
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Gender | Male
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 5600 S 59TH ST STE 104
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City | LINCOLN
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State | NE
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Zip | 68516-2386
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Country | US
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Telephone | 402-484-0595
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Fax | 402-484-6306
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Provider Business Mailing Address
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Address Line | 3001 FLETCHER AVE APT 153
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City | LINCOLN
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State | NE
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Zip | 68504-1031
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Country | US
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Telephone | 402-450-9753
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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 | 3511
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 885
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License Number State | NE
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