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General NPI Number Information
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NPI Number | 1932466539
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Entity Type | Organization
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Legal Business Name | SUMNER COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 2501 LAKERIDGE DR STE. 104C
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City | NORFOLK
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State | NE
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Zip | 68701-2558
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Country | US
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Telephone | 402-640-5569
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Fax | 402-844-3406
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Provider Business Mailing Address
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Address Line | 209 W MAPLE AVE
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City | NORFOLK
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State | NE
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Zip | 68701-4135
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Country | US
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Telephone | 402-640-5569
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Fax | 402-844-3406
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Authorized Official
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Title or Position | COUNSELOR/OWNER
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Name | LATICIA M SUMNER
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Credential | LIMHP
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Telephone | 402-640-5569
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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 | 758, 1290
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License Number State | NE
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