Provider Demographics
NPI:1508947250
Name:BUSKIRK, SONYA ANN (MS, LIMHP, CPC)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:ANN
Last Name:BUSKIRK
Suffix:
Gender:F
Credentials:MS, LIMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5531 W SADDLEHORSE DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-4728
Mailing Address - Country:US
Mailing Address - Phone:308-293-1385
Mailing Address - Fax:
Practice Address - Street 1:124 W 46TH ST STE 204
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8348
Practice Address - Country:US
Practice Address - Phone:308-293-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2500101YM0800X
NE2808101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026851800Medicaid
NE10025857400Medicaid
NE47080518701Medicaid