Healthcare Provider Details

I. General information

NPI: 1104710375
Provider Name (Legal Business Name): ANOINTED PATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 N COTNER BLVD STE 328
LINCOLN NE
68505-2344
US

IV. Provider business mailing address

770 N COTNER BLVD STE 328
LINCOLN NE
68505-2344
US

V. Phone/Fax

Practice location:
  • Phone: 402-417-2524
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KADRA B TALETOVIC
Title or Position: CREDENTIALING
Credential:
Phone: 402-417-2524