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General NPI Number Information
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NPI Number | 1700635497
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Entity Type | Organization
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Legal Business Name | SHARED SOLUTIONS COUNSELING
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 10206 CASPIAN DR
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City | PAPILLION
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State | NE
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Zip | 68046-3234
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Country | US
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Telephone | 402-250-7810
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Fax |
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Provider Business Mailing Address
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Address Line | 10206 CASPIAN DR
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City | PAPILLION
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State | NE
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Zip | 68046-3234
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Country | US
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Telephone | 402-250-7810
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. LONGFELLOW MARQUEZ
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Credential | LIMHP/LDAC
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Telephone | 402-250-7810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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