Provider Demographics
NPI:1639321490
Name:BARTLEY, DUSTIN E (LMHP, LADC, LPC)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:E
Last Name:BARTLEY
Suffix:
Gender:M
Credentials:LMHP, LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 FLETCHER AVE APT 153
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1031
Mailing Address - Country:US
Mailing Address - Phone:402-450-9753
Mailing Address - Fax:
Practice Address - Street 1:5600 S 59TH ST
Practice Address - Street 2:STE 104
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-2386
Practice Address - Country:US
Practice Address - Phone:402-484-0595
Practice Address - Fax:402-484-6306
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3511101YM0800X
NE885101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)