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General NPI Number Information
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NPI Number | 1801576012
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Entity Type | Organization
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Legal Business Name | TERRELL THERAPY
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 3210 LOOKINGGLASS DR
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City | BELLEVUE
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State | NE
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Zip | 68123-2302
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Country | US
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Telephone | 402-595-0780
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Fax | 402-875-6002
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Provider Business Mailing Address
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Address Line | 3210 LOOKINGGLASS DR
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City | BELLEVUE
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State | NE
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Zip | 68123-2302
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Country | US
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Telephone | 402-595-0780
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Fax | 402-875-6002
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY TERRELL
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Credential | LIMHP
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Telephone | 402-595-0780
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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