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General NPI Number Information
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NPI Number | 1326572033
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 3600 VILLAGE DR STE 110
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City | LINCOLN
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State | NE
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Zip | 68516-6631
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Country | US
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Telephone | 402-875-9270
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Fax | 402-875-9272
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Provider Business Mailing Address
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Address Line | 3600 VILLAGE DR STE 110
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City | LINCOLN
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State | NE
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Zip | 68516-6631
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Country | US
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Telephone | 402-875-9270
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Fax | 402-875-9272
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Authorized Official
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Title or Position | COUNSELOR
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Name | AMANDA LINGG
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Credential | LIMHP, LADC
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Telephone | 402-641-8942
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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 | 1214
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License Number State | NE
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