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General NPI Number Information
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NPI Number | 1831237361
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Entity Type | Organization
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Legal Business Name | CAMELOT CARE SERVICES
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1640 S 70TH ST
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City | LINCOLN
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State | NE
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Zip | 68506-1571
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Country | US
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Telephone | 402-484-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 S 70TH ST
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City | LINCOLN
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State | NE
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Zip | 68506-1571
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Country | US
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Telephone | 402-484-6060
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | DANIEL DOUGLAS RASMUSSEN
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Credential | LMHP, LADC
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Telephone | 402-570-6407
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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 | 3141
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License Number State | NE
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