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NPI 1770222333

NPI 1770222333 : LINCOLN MOSAIC THERAPY & CONSULTING : LINCOLN, NE

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General NPI Number Information
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    NPI Number           |    1770222333
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    Entity Type          |    Organization 
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    Legal Business Name  |    LINCOLN MOSAIC THERAPY & CONSULTING 
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Dates
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    Enumeration Date     |    06/01/2022
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    Last Update Date     |    06/01/2022
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Provider Practice Location Address
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    Address Line         |    4830 WILSHIRE BLVD STE 101 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68504-3365
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    Country              |    US
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    Telephone            |    402-430-4240
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2246 N 82ND ST 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68505-3600
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    Country              |    US
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    Telephone            |    402-430-4240
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     KELSEY  SCHILTZ 
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    Credential           |    LICSW
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    Telephone            |    402-430-4240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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