Provider Demographics
NPI:1992861223
Name:ODYSSEY III COUNSELING SERVICES P. C.
Entity Type:Organization
Organization Name:ODYSSEY III COUNSELING SERVICES P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-371-7215
Mailing Address - Street 1:401 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4724
Mailing Address - Country:US
Mailing Address - Phone:402-371-7215
Mailing Address - Fax:402-371-2521
Practice Address - Street 1:401 S 17TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4724
Practice Address - Country:US
Practice Address - Phone:402-371-7215
Practice Address - Fax:402-371-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========26Medicaid