Authentic Self Counseling, Llc | |
11640 Arbor St Ste 101 Omaha NE 68144-5007 | |
(402) 881-0261 | |
Not Available |
Full Name | Authentic Self Counseling, Llc |
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Speciality | Social Worker |
Location | 11640 Arbor St Ste 101, Omaha, Nebraska |
Authorized Official Name and Position | Alexandra Parra (AUTHORIZED REPRESENTATIVE) |
Authorized Official Contact | 5317778917 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Authentic Self Counseling, Llc 3068 S 60th St Apt 28 Omaha NE 68106-4348 Ph: (531) 777-8917 | Authentic Self Counseling, Llc 11640 Arbor St Ste 101 Omaha NE 68144-5007 Ph: (402) 881-0261 |
NPI Number | 1902648272 |
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Provider Enumeration Date | 06/08/2024 |
Last Update Date | 06/10/2024 |
Certification Date | 06/10/2024 |
Medicare PECOS PAC ID | 8224577820 |
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Medicare Enrollment ID | O20240827003878 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902648272 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Alexandra Parra |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1700516317 PECOS PAC ID: 1951750199 Enrollment ID: I20231213000476 |
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