Healthcare Provider Details

I. General information

NPI: 1164331856
Provider Name (Legal Business Name): RESTORED HEATS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 S 87TH ST
OMAHA NE
68124-3040
US

IV. Provider business mailing address

1120 PORT ROYAL DR
PAPILLION NE
68046-8002
US

V. Phone/Fax

Practice location:
  • Phone: 563-503-0420
  • Fax:
Mailing address:
  • Phone: 563-503-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHANNON PERSINGER
Title or Position: THERAPIST / OWNER
Credential: LIMHP, LPC
Phone: 563-503-0420