Provider Demographics
NPI:1073039574
Name:ELISSA MCGILL CONSULTING SERVICES, INC
Entity Type:Organization
Organization Name:ELISSA MCGILL CONSULTING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-709-3140
Mailing Address - Street 1:5518 147TH ST
Mailing Address - Street 2:
Mailing Address - City:WEEPING WATER
Mailing Address - State:NE
Mailing Address - Zip Code:68463-2312
Mailing Address - Country:US
Mailing Address - Phone:402-709-3140
Mailing Address - Fax:
Practice Address - Street 1:830 L ST STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2205
Practice Address - Country:US
Practice Address - Phone:402-709-3140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE719101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty