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622 Liberty Rd Dannebrog NE 68831-3163 | |
| (308) 370-2580 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 622 Liberty Rd, Dannebrog, Nebraska |
| Authorized Official Name and Position | Katherine Donahoo (OWNER) |
| Authorized Official Contact | 3083702580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
622 Liberty Rd Dannebrog NE 68831-3163 Ph: (308) 370-2580 | 622 Liberty Rd Dannebrog NE 68831-3163 Ph: (308) 370-2580 |
| NPI Number | 1881353985 |
|---|---|
| Provider Enumeration Date | 12/16/2021 |
| Last Update Date | 11/18/2023 |
| Certification Date | 11/18/2023 |
| Medicare PECOS PAC ID | 3173976891 |
|---|---|
| Medicare Enrollment ID | O20240130001549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881353985 | NPI | - | NPPES |
| 10026905100 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| Provider Name | Katherine Elizabeth Donahoo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376108076 PECOS PAC ID: 7416300140 Enrollment ID: I20240130001734 |
| Provider Name | Merridie R Kaup |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477196855 PECOS PAC ID: 1456883594 Enrollment ID: I20241015001408 |