Basic Information
Provider Information
NPI: 1417143611
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUSS
FirstName: JOAN
MiddleName: ELIZABETH
NamePrefix: MRS.
NameSuffix:  
Credential: LIMHP, LADC, LMHP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3300 N 60TH ST
Address2:  
City: OMAHA
State: NE
PostalCode: 681043402
CountryCode: US
TelephoneNumber: 4025540520
FaxNumber: 4025518797
Practice Location
Address1: 11111 M ST
Address2:  
City: OMAHA
State: NE
PostalCode: 681372378
CountryCode: US
TelephoneNumber: 4025044099
FaxNumber: 4025043929
Other Information
ProviderEnumerationDate: 09/20/2007
LastUpdateDate: 05/09/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X354NEY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800X2578NEN Behavioral Health & Social Service ProvidersCounselorMental Health
101YM0800X770NEN Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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