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General NPI Number Information
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NPI Number | 1750872149
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Entity Type | Organization
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Legal Business Name | MIND OVER MATTER COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 955 N ADAMS ST STE 8
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City | PAPILLION
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State | NE
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Zip | 68046-3080
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Country | US
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Telephone | 531-444-1963
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Fax |
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Provider Business Mailing Address
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Address Line | 955 N ADAMS ST STE 8
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City | PAPILLION
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State | NE
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Zip | 68046-3080
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Country | US
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Telephone | 531-444-1963
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MYISHA PARSHA
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Credential | LIMHP
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Telephone | 531-444-1963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 5045
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License Number State | NE
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