Healthcare Provider Details

I. General information

NPI: 1750893988
Provider Name (Legal Business Name): REBECCA MOLDEN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 N WASHINGTON ST
LEXINGTON NE
68850-1930
US

IV. Provider business mailing address

305 CHEROKEE RD
LEXINGTON NE
68850-2750
US

V. Phone/Fax

Practice location:
  • Phone: 308-325-7234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1655
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1679
License Number StateNE

VIII. Authorized Official

Name: REBECCA MOLDEN
Title or Position: OWNER/THERAPIST
Credential: LIMHP, CMSW
Phone: 308-325-7234