Provider Demographics
NPI: | 1467975342 |
---|---|
Name: | CAPITOL BEHAVIORAL HEALTH, LLC |
Entity Type: | Organization |
Organization Name: | CAPITOL BEHAVIORAL HEALTH, LLC |
Other - Org Name: | BUI PSYCHOLOGICAL SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PSYCHOLOGIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LEVITA |
Authorized Official - Middle Name: | YEN |
Authorized Official - Last Name: | BUI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD |
Authorized Official - Phone: | 785-691-6688 |
Mailing Address - Street 1: | 808 P ST STE 450 |
Mailing Address - Street 2: | |
Mailing Address - City: | LINCOLN |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68508-1361 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 531-500-1455 |
Mailing Address - Fax: | 877-775-0354 |
Practice Address - Street 1: | 808 P ST # 450 |
Practice Address - Street 2: | |
Practice Address - City: | LINCOLN |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68508-1361 |
Practice Address - Country: | US |
Practice Address - Phone: | 531-500-1455 |
Practice Address - Fax: | 877-775-0354 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-07-21 |
Last Update Date: | 2023-07-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Single Specialty |