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General NPI Number Information
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NPI Number | 1114789708
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Entity Type | Organization
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Legal Business Name | MALLIN COUNSELING LLC
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 7441 O ST STE 201
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City | LINCOLN
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State | NE
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Zip | 68510-2468
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Country | US
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Telephone | 402-905-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 900 ELDON DR
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City | LINCOLN
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State | NE
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Zip | 68510-4014
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Country | US
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Telephone | 402-802-8695
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | VICTOR MALLIN
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Credential |
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Telephone | 402-905-2545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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