Provider Demographics
NPI:1255852315
Name:CALM WATERS COUNSELING, LLC
Entity Type:Organization
Organization Name:CALM WATERS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPEC.
Authorized Official - Prefix:
Authorized Official - First Name:TOMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-885-7672
Mailing Address - Street 1:11605 ARBOR ST STE 106
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2982
Mailing Address - Country:US
Mailing Address - Phone:402-330-4700
Mailing Address - Fax:402-330-8815
Practice Address - Street 1:11605 ARBOR ST STE 106
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2982
Practice Address - Country:US
Practice Address - Phone:402-330-4700
Practice Address - Fax:402-330-8815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty