Healthcare Provider Details

I. General information

NPI: 1750872149
Provider Name (Legal Business Name): MIND OVER MATTER COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 N ADAMS ST STE 8
PAPILLION NE
68046-3080
US

IV. Provider business mailing address

955 N ADAMS ST STE 8
PAPILLION NE
68046-3080
US

V. Phone/Fax

Practice location:
  • Phone: 531-444-1963
  • Fax:
Mailing address:
  • Phone: 531-444-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number5045
License Number StateNE

VIII. Authorized Official

Name: MYISHA PARSHA
Title or Position: OWNER
Credential: LIMHP
Phone: 531-444-1963