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General NPI Number Information
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NPI Number | 1659025252
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Entity Type | Organization
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Legal Business Name | CHANGEYOU COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 2236 GREGG RD APT 6
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City | BELLEVUE
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State | NE
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Zip | 68123-4069
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Country | US
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Telephone | 402-322-2880
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Fax |
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Provider Business Mailing Address
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Address Line | 2236 GREGG RD APT 6
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City | BELLEVUE
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State | NE
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Zip | 68123-4069
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Country | US
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Telephone | 402-322-2880
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | KIMBERLY GRUBB
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Credential | LMHP, LADC
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Telephone | 402-322-2880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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