Healthcare Provider Details

I. General information

NPI: 1740890664
Provider Name (Legal Business Name): THERAPEUTIC CHOICES COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 E B ST
NORTH PLATTE NE
69101-5457
US

IV. Provider business mailing address

218 E B ST
NORTH PLATTE NE
69101-5457
US

V. Phone/Fax

Practice location:
  • Phone: 308-221-5288
  • Fax: 308-221-5306
Mailing address:
  • Phone: 308-221-5288
  • Fax: 308-221-5306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEANIE SHIMMIN
Title or Position: MANAGING MEMBER
Credential: LIMHP
Phone: 308-221-5288