Provider Demographics
NPI:1376707794
Name:DESTINY COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:DESTINY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:308-254-0737
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:1023 10TH AVENUE
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-0214
Mailing Address - Country:US
Mailing Address - Phone:308-254-0737
Mailing Address - Fax:308-254-6375
Practice Address - Street 1:1023 10TH AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-1611
Practice Address - Country:US
Practice Address - Phone:308-254-0737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1999101YM0800X
NE3260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty