Healthcare Provider Details

I. General information

NPI: 1568309672
Provider Name (Legal Business Name): KIMBERLY ELLENBERGER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 N 13TH ST STE 100
NORFOLK NE
68701-2591
US

IV. Provider business mailing address

859 4TH ST
MEADOW GROVE NE
68752-4006
US

V. Phone/Fax

Practice location:
  • Phone: 402-841-6631
  • 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: KIMBERLY ELLENBERGER
Title or Position: OWNER
Credential: LIMHP
Phone: 402-841-5376