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General NPI Number Information
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NPI Number | 1720563570
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Entity Type | Organization
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Legal Business Name | TRIUMPHANT MIND COUNSELING, LLC
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 11707 S 110TH AVE
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City | PAPILLION
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State | NE
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Zip | 68046-5555
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Country | US
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Telephone | 402-681-3651
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Fax |
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Provider Business Mailing Address
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Address Line | 11707 S 110TH AVE
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City | PAPILLION
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State | NE
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Zip | 68046-5555
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Country | US
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Telephone | 402-681-3651
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROGER A SHERMAN
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Credential | LICSW, LIMHP, PLMHP
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Telephone | 402-681-3651
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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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