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Individual
MR. KENNETH JAMES MAUSBACH
Active
Individual
MR. KENNETH JAMES MAUSBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2498
NE
1041C0700X
Clinical Social Worker
Primary
1055
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025734000
—
NE
01
—
249035
MIDLANDS INSURANCE
NE
01
—
456304000
MAGELLAN
NE
05
—
47075636926
—
NE
05
—
47075636930
—
NE
05
—
47075636998
—
NE
01
—
82144
NE BLUE CROSS & BLUE SHEILD
NE
Enumeration date
10/29/2008
Last updated
11/20/2009
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