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General NPI Number Information
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NPI Number | 1205464542
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Entity Type | Organization
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Legal Business Name | ENLIGHTENED COUNSELING & HEALING LLC
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 5824 S 142ND ST STE B
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City | OMAHA
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State | NE
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Zip | 68137-2872
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Country | US
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Telephone | 402-235-9686
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Fax |
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Provider Business Mailing Address
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Address Line | 5824 S 142ND ST STE B
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City | OMAHA
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State | NE
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Zip | 68137-2872
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Country | US
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Telephone | 402-235-9686
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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 | JAIME WEATHERHOLT
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Credential |
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Telephone | 402-235-9686
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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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