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General NPI Number Information
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NPI Number | 1013425925
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Entity Type | Organization
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Legal Business Name | SHADOIN COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 18322 JONES ST
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City | ELKHORN
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State | NE
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Zip | 68022-5675
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Country | US
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Telephone | 402-496-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 18322 JONES ST
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City | ELKHORN
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State | NE
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Zip | 68022-5675
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Country | US
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Telephone | 402-496-6258
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LINDA M. SHADOIN-GRIER
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Credential |
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Telephone | 402-659-7061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1628
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License Number State | NE
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