Provider Demographics
NPI:1609595511
Name:CAITLIN EMBKE COUNSELING LLC
Entity Type:Organization
Organization Name:CAITLIN EMBKE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:EMBKE
Authorized Official - Suffix:
Authorized Official - Credentials:PLMHP, PLADC
Authorized Official - Phone:402-780-1564
Mailing Address - Street 1:7025 S 115TH STREET PLZ APT 208
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-4780
Mailing Address - Country:US
Mailing Address - Phone:402-980-5058
Mailing Address - Fax:
Practice Address - Street 1:11615 I ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1211
Practice Address - Country:US
Practice Address - Phone:402-780-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty