Healthcare Provider Details

I. General information

NPI: 1538583216
Provider Name (Legal Business Name): ACORN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 AVENUE I STE D
SCOTTSBLUFF NE
69361-4586
US

IV. Provider business mailing address

3321 AVENUE I STE D
SCOTTSBLUFF NE
69361-4586
US

V. Phone/Fax

Practice location:
  • Phone: 402-890-1707
  • Fax: 308-635-7412
Mailing address:
  • Phone: 402-890-1707
  • Fax: 308-635-7412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1141
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1980
License Number StateNE

VIII. Authorized Official

Name: KRISTIN ANN LARSON
Title or Position: COUNSELOR
Credential: LIMHP, LPC,
Phone: 402-890-1707