Provider Demographics
NPI:1407454358
Name:NEBO COUNSELING, LLC
Entity Type:Organization
Organization Name:NEBO COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKY
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-368-8864
Mailing Address - Street 1:1462 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-2702
Mailing Address - Country:US
Mailing Address - Phone:801-368-8864
Mailing Address - Fax:
Practice Address - Street 1:62 E 300 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1859
Practice Address - Country:US
Practice Address - Phone:801-385-4481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health