Provider Demographics
NPI:1114537529
Name:MEDICINE CREEK COUNSELING
Entity Type:Organization
Organization Name:MEDICINE CREEK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SHIFFLET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMHP
Authorized Official - Phone:308-737-3051
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NE
Mailing Address - Zip Code:69022-0297
Mailing Address - Country:US
Mailing Address - Phone:308-641-6387
Mailing Address - Fax:
Practice Address - Street 1:301 NELSON STREET
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NE
Practice Address - Zip Code:69022-3592
Practice Address - Country:US
Practice Address - Phone:308-737-3051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health