=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952264285
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH CENTRAL BEHAVIORAL SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2025
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 724 S BURLINGTON AVE
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68901-5913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-462-0148
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2066
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68902-2066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-462-0148
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COMMUNITY SUPPORT WORKER
-----------------------------------------------------
Name | SARAH JO SWEENEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-462-0148
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------