Healthcare Provider Details

I. General information

NPI: 1235915208
Provider Name (Legal Business Name): UNLEASHED COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 BROADWAY STE 107
SCOTTSBLUFF NE
69361-3184
US

IV. Provider business mailing address

1517 BROADWAY STE 107
SCOTTSBLUFF NE
69361-3184
US

V. Phone/Fax

Practice location:
  • Phone: 308-765-8619
  • Fax:
Mailing address:
  • Phone: 308-765-8619
  • Fax: 308-222-8711

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: APRIL HIEATT
Title or Position: OWNER/LIMHP
Credential: M.S.,LIMHP, CPC, NCC
Phone: 308-765-8619