Provider Demographics
NPI:1447356233
Name:BUCHTA, LISA G (PHD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:G
Last Name:BUCHTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:908 N HOWARD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3529
Mailing Address - Country:US
Mailing Address - Phone:308-398-6050
Mailing Address - Fax:308-398-6051
Practice Address - Street 1:908 N HOWARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3529
Practice Address - Country:US
Practice Address - Phone:083-986-0503
Practice Address - Fax:308-398-6051
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE831103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE96097OtherBCBS AUXILARY
NE96097OtherBCBS AUXILARY