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NPI Code Detail

MEDICARE: PATH OF LIGHT COUNSELING

MEDICARE: PATH OF LIGHT COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor329NE

General Provider Information

NPI Number : 1508139304
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATH OF LIGHT COUNSELING
Provider Business Mailing Address
First Line : 5437 N 103RD STRRET
Second Line :
City : OMAHA
State : NE
Zip : 68134-1002
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5437 N 103RD STRRET
Second Line :
City : OMAHA
State : NE
Zip : 68134-1002
Country : US
Telephone Number : 402-496-9966
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BARBARA ESCAMILLA
Credential :
Telephone Number : 402-496-9966
Provider Enumeration Date : 02/10/2012
Last Update Date : 02/10/2012

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Directions to “PATH OF LIGHT COUNSELING ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.