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General NPI Number Information
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NPI Number | 1629708995
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Entity Type | Organization
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Legal Business Name | CORE COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 101 ENTERPRISE DR
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City | GRETNA
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State | NE
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Zip | 68028-7943
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Country | US
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Telephone | 402-207-6533
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Fax | 402-614-6174
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Provider Business Mailing Address
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Address Line | 101 ENTERPRISE DR
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City | GRETNA
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State | NE
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Zip | 68028-7943
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Country | US
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Telephone | 402-207-6533
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Fax | 402-614-6174
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Authorized Official
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Title or Position | OWNER
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Name | LINDSAY STAYTON
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Credential | LIMHP
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Telephone | 402-207-6533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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