=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245043462
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KLR COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2025
-----------------------------------------------------
Last Update Date | 02/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 PINE LAKE RD STE 200
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68512-3604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-261-8313
-----------------------------------------------------
Fax | 866-321-6448
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 PINE LAKE RD STE 200
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68512-3604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-261-8313
-----------------------------------------------------
Fax | 866-321-6448
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KLR COUNSELING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-261-8313
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------