Provider Demographics
NPI:1659880425
Name:HIDDEN DIMENSIONS COUNSELING
Entity Type:Organization
Organization Name:HIDDEN DIMENSIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LIMHP, LIPC
Authorized Official - Phone:402-575-9499
Mailing Address - Street 1:3205 POPPLETON AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2062
Mailing Address - Country:US
Mailing Address - Phone:402-639-4757
Mailing Address - Fax:
Practice Address - Street 1:2808 N 75TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6861
Practice Address - Country:US
Practice Address - Phone:402-575-9499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE109101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty