Healthcare Provider Details

I. General information

NPI: 1255928297
Provider Name (Legal Business Name): ALLY COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 01/09/2021
Certification Date: 01/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 N 4TH ST STE 108
ONEILL NE
68763-1317
US

IV. Provider business mailing address

614 N 4TH ST STE 108
ONEILL NE
68763-1317
US

V. Phone/Fax

Practice location:
  • Phone: 402-336-1306
  • Fax: 402-336-1246
Mailing address:
  • Phone: 402-336-1306
  • Fax: 402-336-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL DEAN WILLIAMSON
Title or Position: OWNER/THERAPIST
Credential: MSE, LIMHP, LPC
Phone: 402-336-7172