Healthcare Provider Details

I. General information

NPI: 1245043462
Provider Name (Legal Business Name): KLR COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 PINE LAKE RD STE 200
LINCOLN NE
68512-3604
US

IV. Provider business mailing address

2001 PINE LAKE RD STE 200
LINCOLN NE
68512-3604
US

V. Phone/Fax

Practice location:
  • Phone: 402-261-8313
  • Fax: 866-321-6448
Mailing address:
  • Phone: 402-261-8313
  • Fax: 866-321-6448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KLR COUNSELING
Title or Position: OWNER
Credential:
Phone: 402-261-8313