Provider Demographics
NPI:1972141893
Name:INCREMENTLING PEACE COUNSELING SERVICES LLC.
Entity Type:Organization
Organization Name:INCREMENTLING PEACE COUNSELING SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:MOSLEY SR.
Authorized Official - Suffix:SR
Authorized Official - Credentials:PLADC
Authorized Official - Phone:402-298-0136
Mailing Address - Street 1:4206 NORTH 94TH STREET
Mailing Address - Street 2:HOUSE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3948
Mailing Address - Country:US
Mailing Address - Phone:402-298-0136
Mailing Address - Fax:531-484-2781
Practice Address - Street 1:3035 HARNEY STREET
Practice Address - Street 2:TAMARAK BUILDING SUITE 101 G
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3500
Practice Address - Country:US
Practice Address - Phone:531-389-8110
Practice Address - Fax:531-484-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty