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General NPI Number Information
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NPI Number | 1851171011
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Entity Type | Organization
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Legal Business Name | WELLNESS COUNSELING
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 120 E 6TH ST STE 4B
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City | LEXINGTON
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State | NE
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Zip | 68850-1905
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Country | US
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Telephone | 402-499-4028
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Fax | 308-832-9622
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Provider Business Mailing Address
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Address Line | 1505 N TYLER ST
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City | LEXINGTON
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State | NE
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Zip | 68850-1431
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Country | US
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Telephone | 402-499-4028
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Fax | 308-832-9622
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Authorized Official
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Title or Position | THERAPIST
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Name | VICTORIA BROCK
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Credential | LIMHP, LADC
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Telephone | 402-499-4028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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