Provider Demographics
NPI:1811311665
Name:KEARNEY COUNSELING ASSOCIATES LLC
Entity type:Organization
Organization Name:KEARNEY COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:ORA
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LADC
Authorized Official - Phone:308-237-6865
Mailing Address - Street 1:2811 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4036
Mailing Address - Country:US
Mailing Address - Phone:308-237-6865
Mailing Address - Fax:308-236-7698
Practice Address - Street 1:2811 30TH AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-4036
Practice Address - Country:US
Practice Address - Phone:308-237-6865
Practice Address - Fax:308-236-7698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARV CROUCH COUNSELING SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-14
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE296101YA0400X
NE35101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty