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General NPI Number Information
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NPI Number | 1235705591
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Entity Type | Organization
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Legal Business Name | SELAH COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 1345 S 16TH ST
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City | LINCOLN
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State | NE
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Zip | 68502-1466
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Country | US
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Telephone | 402-413-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 3430 PAWNEE ST
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City | LINCOLN
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State | NE
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Zip | 68506-3252
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Country | US
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Telephone | 402-413-1811
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MICHAELA IRENE KADAVY
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Credential | MA, LMHP
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Telephone | 402-413-1811
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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 |
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License Number State |
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