Provider Demographics
NPI:1922457431
Name:CONFIDENTIAL COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:CONFIDENTIAL COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COUNT
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:I
Authorized Official - Credentials:LMHP
Authorized Official - Phone:402-457-5761
Mailing Address - Street 1:1941 S 42ND ST
Mailing Address - Street 2:110
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2939
Mailing Address - Country:US
Mailing Address - Phone:402-457-5761
Mailing Address - Fax:402-932-3128
Practice Address - Street 1:1941 S 42ND ST
Practice Address - Street 2:110
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2939
Practice Address - Country:US
Practice Address - Phone:402-457-5761
Practice Address - Fax:402-932-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3199251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025359100Medicaid