Healthcare Provider Details

I. General information

NPI: 1437016136
Provider Name (Legal Business Name): COR THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 2ND ST STE 3
WAYNE NE
68787-1957
US

IV. Provider business mailing address

120 W 2ND ST STE 3
WAYNE NE
68787-1957
US

V. Phone/Fax

Practice location:
  • Phone: 402-500-6870
  • Fax: 402-500-6871
Mailing address:
  • Phone: 402-500-6870
  • Fax: 402-500-6871

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: NICOLE E KETTLER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 402-500-6870