Healthcare Provider Details

I. General information

NPI: 1649127572
Provider Name (Legal Business Name): PMA COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 NORMAL BLVD STE 265
LINCOLN NE
68506-2891
US

IV. Provider business mailing address

5131 QUAIL RIDGE DR
LINCOLN NE
68516-1852
US

V. Phone/Fax

Practice location:
  • Phone: 402-310-6947
  • 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: BROCK WETTSTEAD
Title or Position: OWNER
Credential:
Phone: 402-310-6947