MEDICARE: CARITAS COUNSELING INC.

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
1	1041C0700X	Clinical Social Worker	1481	NE

General Provider Information

NPI Number	:	1548794985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARITAS COUNSELING INC.

Provider Business Mailing Address
First Line	:	8424 W CENTER RD STE 209
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-3138
Country	:	US
Telephone Number	:	402-330-2691
Fax Number	:	844-389-5770

Provider Business Practice Location Address
First Line	:	8424 W CENTER RD STE 209
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-3138
Country	:	US
Telephone Number	:	402-881-8129
Fax Number	:	844-389-5770

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JENNIFER MADRIGAL
Credential	:	LCSW, LIMHP
Telephone Number	:	402-216-0143

Provider Enumeration Date	:	04/12/2017
Last Update Date	:	09/24/2020

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