Healthcare Provider Details

I. General information

NPI: 1881353985
Provider Name (Legal Business Name): BLUE ELEPHANT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 11/18/2023
Certification Date: 11/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 LIBERTY RD
DANNEBROG NE
68831-3163
US

IV. Provider business mailing address

622 LIBERTY RD
DANNEBROG NE
68831-3163
US

V. Phone/Fax

Practice location:
  • Phone: 308-370-2580
  • Fax:
Mailing address:
  • Phone: 308-370-2580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHERINE DONAHOO
Title or Position: OWNER
Credential: LIMHP
Phone: 308-370-2580