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NPI Code Detail

MEDICARE: BRIAN CROUSE LIPC

MEDICARE:   BRIAN  CROUSE  LIPC
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
1101YM0800XMental Health Counselor989NE
2101YM0800XMental Health Counselor3779NE
3101YP2500XProfessional Counselor1880NE

General Provider Information

NPI Number : 1295169704
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN CROUSE LIPC
Provider Business Mailing Address
First Line : 604 N SAINT JOSEPH AVE
Second Line :
City : HASTINGS
State : NE
Zip : 68901-7530
Country : US
Telephone Number : 402-310-5607
Fax Number : 360-363-5607
Provider Business Practice Location Address
First Line : 604 N SAINT JOSEPH AVE
Second Line :
City : HASTINGS
State : NE
Zip : 68901-7530
Country : US
Telephone Number : 402-310-5607
Fax Number : 360-363-5607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2013
Last Update Date : 09/03/2013

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Directions to “ BRIAN CROUSE LIPC” Practice Location

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