=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740604685
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIANA P FEGENBUSH MS, LMHP, LIMHP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2014
-----------------------------------------------------
Last Update Date | 01/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13304 W CENTER RD STE 203
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68144-3457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-512-0083
-----------------------------------------------------
Fax | 712-889-0242
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13304 W CENTER RD STE 203
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68144-3457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-512-0083
-----------------------------------------------------
Fax | 712-889-0242
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 2241
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------