MEDICARE: BRIAN PAUL OBRIST LIMHP, LCSW, PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	1664	NE
2	104100000X	Social Worker	1243	NE
3	101YM0800X	Mental Health Counselor	3251	NE

General Provider Information

NPI Number	:	1205024155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN PAUL OBRIST LIMHP, LCSW, PA-C

Provider Business Mailing Address
First Line	:	4321 41ST AVENUE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68602-1028
Country	:	US
Telephone Number	:	402-562-7500
Fax Number	:	402-564-0611

Provider Business Practice Location Address
First Line	:	4321 41ST AVENUE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68602-1028
Country	:	US
Telephone Number	:	402-562-7500
Fax Number	:	402-564-0611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	12/02/2024

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