Basic Information
| Provider Information | |||||||||
| NPI: | 1518363548 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRUNDEGE | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | |||||||||
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| Credential: | LIMHP, LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 K ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685082960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024740011 | ||||||||
| FaxNumber: | 4024740012 | ||||||||
| Practice Location | |||||||||
| Address1: | 4600 VALLEY RD STE 350 | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685104844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024740011 | ||||||||
| FaxNumber: | 4024740012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2014 | ||||||||
| LastUpdateDate: | 06/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YA0400X | 1175 | NE | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 1933 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.