Provider Demographics
NPI:1952084592
Name:CUSHING, SARA BRIANNE
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BRIANNE
Last Name:CUSHING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 MATTHIES DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2914
Mailing Address - Country:US
Mailing Address - Phone:402-943-9501
Mailing Address - Fax:
Practice Address - Street 1:3535 PADDOCK RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3827
Practice Address - Country:US
Practice Address - Phone:402-390-6465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE78921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical