Provider Demographics
NPI:1023895828
Name:PEACE AND VITALITY COUNSELING LLC
Entity type:Organization
Organization Name:PEACE AND VITALITY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FINAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LIMHP
Authorized Official - Phone:402-321-2086
Mailing Address - Street 1:7909 ELM PLZ APT 204
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3489
Mailing Address - Country:US
Mailing Address - Phone:402-321-2086
Mailing Address - Fax:
Practice Address - Street 1:11717 BURT ST STE 101
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-1500
Practice Address - Country:US
Practice Address - Phone:402-321-2086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty