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General NPI Number Information
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NPI Number | 1790029734
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Entity Type | Organization
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Legal Business Name | KLOCH COUNSELING
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 101 W 8TH ST SUITE A
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City | LEXINGTON
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State | NE
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Zip | 68850-1971
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Country | US
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Telephone | 308-324-7017
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Fax | 866-578-3559
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Provider Business Mailing Address
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Address Line | 101 W 8TH ST SUITE A
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City | LEXINGTON
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State | NE
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Zip | 68850-1971
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Country | US
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Telephone | 308-324-7017
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Fax | 866-578-3559
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUSAN M KLOCH
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Credential | LICSW, LADC
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Telephone | 308-324-7017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 986
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 955
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 986
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License Number State | NE
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