Basic Information
| Provider Information | |||||||||
| NPI: | 1164146833 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUSING | ||||||||
| FirstName: | KAEL | ||||||||
| MiddleName: | GERHARDT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSC, PLMHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11030 LEAVENWORTH ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681543354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4022103121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 230 E 22ND ST | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680252661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027271592 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2022 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 12601 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.