Provider Demographics
NPI:1881206720
Name:CRAFT COUNSELING CO LLC
Entity Type:Organization
Organization Name:CRAFT COUNSELING CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOUSEL
Authorized Official - Suffix:
Authorized Official - Credentials:PLMHP
Authorized Official - Phone:765-490-0929
Mailing Address - Street 1:830 L ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2205
Mailing Address - Country:US
Mailing Address - Phone:765-490-0929
Mailing Address - Fax:
Practice Address - Street 1:830 L ST STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2205
Practice Address - Country:US
Practice Address - Phone:765-490-0929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty