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General NPI Number Information
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NPI Number | 1649625658
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Entity Type | Organization
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Legal Business Name | PEACE, HOPE AND LIFE COUNSELING, INC
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 1811 W 2ND ST STE 450
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5473
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Country | US
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Telephone | 308-382-8085
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Fax | 308-339-0962
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Provider Business Mailing Address
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Address Line | 1811 W 2ND ST STE 450
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5473
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Country | US
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Telephone | 308-382-8085
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Fax | 308-339-0962
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KAYE MINDT LONG
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Credential | LCSW, LIMHP
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Telephone | 308-382-8085
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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 | 10782, P-1372
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 320, 787, 511
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1249, 4370, 2124
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License Number State | NE
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