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NPI Code Detail

MEDICARE: SONIA M KOUNOVSKY BS LADC

MEDICARE: SONIA M KOUNOVSKY BS LADC
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
1101Y00000XCounselor94NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
192115OTHERBCBS AUXILLIARY PROVIDER
285380OTHERBCBS DIRECT PROVIDER

General Provider Information

NPI Number : 1780616193
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONIA M KOUNOVSKY BS LADC
Provider Business Mailing Address
First Line : 110 N BAILEY AVE
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-5436
Country : US
Telephone Number : 308-534-6029
Fax Number : 308-534-6961
Provider Business Practice Location Address
First Line : 110 N BAILEY AVE
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-5436
Country : US
Telephone Number : 308-534-6029
Fax Number : 308-534-6961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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