=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871455857
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIVEWELL COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2025
-----------------------------------------------------
Last Update Date | 11/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2217 W 12TH ST
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68901-3618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-469-6295
-----------------------------------------------------
Fax | 402-469-6295
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2303 W 9TH ST
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68901-3530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-469-6295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL MENTAL HEALTH COUNSELOR
-----------------------------------------------------
Name | SUMMER JOY MELROY
-----------------------------------------------------
Credential | PLMHP
-----------------------------------------------------
Telephone | 402-469-6295
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------