=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992595540
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SELAH THERAPY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2025
-----------------------------------------------------
Last Update Date | 12/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5814 S 142ND ST STE B
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68137-2855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-881-0059
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11517 S 191ST AVE
-----------------------------------------------------
City | GRETNA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68028-3586
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-366-9800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, LMSW, LIMHP
-----------------------------------------------------
Name | KATHRYN M THOMPSON
-----------------------------------------------------
Credential | LMSW, LIMHP
-----------------------------------------------------
Telephone | 605-366-9800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------