Provider Demographics
NPI:1114132958
Name:HUGUNIN, BRUCE DOUGLASS (LMHP, LADC,)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:DOUGLASS
Last Name:HUGUNIN
Suffix:
Gender:M
Credentials:LMHP, LADC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 N 169TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2650
Mailing Address - Country:US
Mailing Address - Phone:402-813-2235
Mailing Address - Fax:402-502-1282
Practice Address - Street 1:3223 N 169TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2650
Practice Address - Country:US
Practice Address - Phone:402-813-2235
Practice Address - Fax:402-502-1282
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE523101YA0400X
NE2399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1013003623OtherGROUP NPI NUMBER FOR A BE