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General NPI Number Information
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NPI Number | 1508265802
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Entity Type | Organization
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Legal Business Name | GUETHLEIN PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 108 E 2ND ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5430
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Country | US
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Telephone | 308-534-8383
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Fax | 308-534-6570
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Provider Business Mailing Address
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Address Line | 108 E 2ND ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5430
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Country | US
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Telephone | 308-534-8383
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Fax | 308-534-6570
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KRISTEN CORFIELD
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Credential |
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Telephone | 308-534-8383
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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 | 497
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License Number State | NE
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