=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669755765
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARI R SUGHROUE LMHP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2011
-----------------------------------------------------
Last Update Date | 07/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1616 WEST AVE
-----------------------------------------------------
City | HOLDREGE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68949-1334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-417-2524
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1616 WEST AVE
-----------------------------------------------------
City | HOLDREGE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68949-1334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-999-9187
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 9043
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------