Provider Demographics
NPI:1235705591
Name:SELAH COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:SELAH COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:KADAVY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHP
Authorized Official - Phone:402-413-1811
Mailing Address - Street 1:3430 PAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3252
Mailing Address - Country:US
Mailing Address - Phone:402-413-1811
Mailing Address - Fax:
Practice Address - Street 1:1345 S 16TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-1466
Practice Address - Country:US
Practice Address - Phone:402-413-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467801159OtherAARON KADAVY NPI