Provider Demographics
NPI:1982155594
Name:FORWARD THINKING COUNSELING, LLC
Entity Type:Organization
Organization Name:FORWARD THINKING COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:308-765-1386
Mailing Address - Street 1:2621 5TH AVE STE 4
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1781
Mailing Address - Country:US
Mailing Address - Phone:308-765-1386
Mailing Address - Fax:308-633-2504
Practice Address - Street 1:2621 5TH AVE STE 4
Practice Address - Street 2:SUITE 4
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1781
Practice Address - Country:US
Practice Address - Phone:308-765-1386
Practice Address - Fax:308-633-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3515101Y00000X
NE1063101YA0400X
NE624101YM0800X
NE2050101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty