Provider Demographics
NPI:1770070401
Name:KROLL COUNSELING LLC
Entity type:Organization
Organization Name:KROLL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITHE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KROLL
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LADC
Authorized Official - Phone:308-995-6548
Mailing Address - Street 1:413 EAST AVE.
Mailing Address - Street 2:P.O. BOX 466
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-2216
Mailing Address - Country:US
Mailing Address - Phone:308-995-6548
Mailing Address - Fax:308-995-6555
Practice Address - Street 1:413 EAST AVE
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-2216
Practice Address - Country:US
Practice Address - Phone:308-995-6548
Practice Address - Fax:308-995-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026721600Medicaid