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General NPI Number Information
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NPI Number | 1861036923
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Entity Type | Organization
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Legal Business Name | E5COUNSELING, LLC
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Dates
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Enumeration Date | 11/01/2019
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 2315 W 39TH ST STE 113
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City | KEARNEY
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State | NE
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Zip | 68845-8327
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Country | US
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Telephone | 308-224-2240
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2245
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City | KEARNEY
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State | NE
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Zip | 68848-2245
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Country | US
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Telephone | 308-224-2240
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | TROY CLAYTON
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Credential | PLMHP
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Telephone | 308-224-2240
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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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