Provider Demographics
NPI:1255928297
Name:ALLY COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ALLY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSE, LIMHP, LPC
Authorized Official - Phone:402-336-7172
Mailing Address - Street 1:614 N 4TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1317
Mailing Address - Country:US
Mailing Address - Phone:402-336-1306
Mailing Address - Fax:402-336-1246
Practice Address - Street 1:614 N 4TH ST STE 108
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1317
Practice Address - Country:US
Practice Address - Phone:402-336-1306
Practice Address - Fax:402-336-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder