Healthcare Provider Details

I. General information

NPI: 1750504569
Provider Name (Legal Business Name): ROCK BRIDGE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 E 3RD ST
FREMONT NE
68025-6334
US

IV. Provider business mailing address

1032 E 3RD ST
FREMONT NE
68025-6334
US

V. Phone/Fax

Practice location:
  • Phone: 402-720-4518
  • Fax: 402-727-6790
Mailing address:
  • Phone: 402-720-4518
  • Fax: 402-727-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2423
License Number StateNE

VIII. Authorized Official

Name: CHRISTY JEAN MEYER
Title or Position: DIRECTOR
Credential: LMHP
Phone: 402-720-4518