Provider Demographics
NPI:1265674972
Name:ENVISION COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:ENVISION COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OCZKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LIMHP
Authorized Official - Phone:402-571-3995
Mailing Address - Street 1:3213 N. 90TH ST.
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134
Mailing Address - Country:US
Mailing Address - Phone:402-571-3995
Mailing Address - Fax:402-571-3980
Practice Address - Street 1:3213 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4707
Practice Address - Country:US
Practice Address - Phone:402-571-3995
Practice Address - Fax:402-571-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty