Healthcare Provider Details

I. General information

NPI: 1821907163
Provider Name (Legal Business Name): NIGHTHAWK COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1596 S US 93
ELY NV
89301-9629
US

IV. Provider business mailing address

1596 S US 93
ELY NV
89301-9629
US

V. Phone/Fax

Practice location:
  • Phone: 601-397-4273
  • Fax:
Mailing address:
  • Phone: 601-397-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CAELIN HANNA KENNEDY
Title or Position: MANAGING MEMBER
Credential: CPC
Phone: 601-397-4273