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NPI Code Detail

MEDICARE: COR THERAPEUTIC SERVICES, LLC

MEDICARE: COR THERAPEUTIC SERVICES, LLC
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 Counselor

General Provider Information

NPI Number : 1750987848
Entity Type Code : Organization
Provider Name (Legal Business Name) : COR THERAPEUTIC SERVICES, LLC
Provider Business Mailing Address
First Line : 1203 S 8TH ST
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5875
Country : US
Telephone Number : 402-500-6870
Fax Number :
Provider Business Practice Location Address
First Line : 3805 25TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-2233
Country : US
Telephone Number : 402-500-6870
Fax Number : 402-500-6871
Authorized Official
Title or Position : OWNER
Name : STEPHANIE WRAGGE
Credential :
Telephone Number : 402-640-5570
Provider Enumeration Date : 12/05/2020
Last Update Date : 03/06/2026

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