Provider Demographics
NPI:1003498916
Name:CHARIS COUNSELING, LLC
Entity Type:Organization
Organization Name:CHARIS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-670-5145
Mailing Address - Street 1:2145 COLFAX ST
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1819
Mailing Address - Country:US
Mailing Address - Phone:402-670-5145
Mailing Address - Fax:
Practice Address - Street 1:5814 S 142ND ST STE B
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2855
Practice Address - Country:US
Practice Address - Phone:402-909-1332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026866100Medicaid