Provider Demographics
NPI:1013425925
Name:SHADOIN COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:SHADOIN COUNSELING AND CONSULTING, LLC
Other - Org Name:SHADOIN COUNSELING AND CONSULTING
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHADOIN-GRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-659-7061
Mailing Address - Street 1:18322 JONES ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5675
Mailing Address - Country:US
Mailing Address - Phone:402-496-6258
Mailing Address - Fax:
Practice Address - Street 1:18322 JONES ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-5675
Practice Address - Country:US
Practice Address - Phone:402-496-6258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1628101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty