Provider Demographics
NPI:1639377880
Name:BONEBRIGHT, CURTIS O (LADC)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:O
Last Name:BONEBRIGHT
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 O ST STE 5
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1510
Mailing Address - Country:US
Mailing Address - Phone:402-742-9616
Mailing Address - Fax:402-742-9116
Practice Address - Street 1:3200 O ST STE 5
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1510
Practice Address - Country:US
Practice Address - Phone:402-742-9616
Practice Address - Fax:402-742-9116
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE490101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)