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General NPI Number Information
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NPI Number | 1316460231
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Entity Type | Organization
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Legal Business Name | TAMMY ERICKSON COUNSELING, LLC
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 2121 N WEBB RD STE 307
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City | GRAND ISLAND
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State | NE
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Zip | 68803-1751
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Country | US
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Telephone | 308-383-7950
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Fax | 308-795-2247
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Provider Business Mailing Address
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Address Line | 649 HIGHWAY 92
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City | PALMER
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State | NE
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Zip | 68864-1121
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Country | US
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Telephone | 308-383-7950
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Fax | 308-795-8847
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Authorized Official
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Title or Position | CREDENTIALING/BILLING MANG.
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Name | TOMEKA C JOHNSON
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Credential | MBRS
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Telephone | 402-885-7672
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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 | 1363
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License Number State | NE
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