| Creative Counseling And Studio, Llc | |
|
1941 S 42nd St Ste 542 Omaha NE 68105-2945 | |
| (402) 401-4445 | |
| (402) 702-0583 |
| Full Name | Creative Counseling And Studio, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1941 S 42nd St Ste 542, Omaha, Nebraska |
| Authorized Official Name and Position | Yasmin S Tucker (PROVIDER/OWNER) |
| Authorized Official Contact | 4024014445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Counseling And Studio, Llc 1941 S 42nd St Ste 542 Omaha NE 68105-2945 Ph: (402) 401-4445 | Creative Counseling And Studio, Llc 1941 S 42nd St Ste 542 Omaha NE 68105-2945 Ph: (402) 401-4445 |
| NPI Number | 1205477585 |
|---|---|
| Provider Enumeration Date | 10/08/2019 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Medicare PECOS PAC ID | 9830532621 |
|---|---|
| Medicare Enrollment ID | O20240208002519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205477585 | NPI | - | NPPES |
| 1043685639 | Medicaid | NE | |
| 100267994-01 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sara Chavez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326564865 PECOS PAC ID: 0749645596 Enrollment ID: I20230429000276 |
| Provider Name | Jennifer Hedke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952945446 PECOS PAC ID: 0840633640 Enrollment ID: I20240208002816 |
| Provider Name | Kristi Bierbaum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407105976 PECOS PAC ID: 7012351521 Enrollment ID: I20240222003069 |
| Provider Name | Yasmin Henderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043685639 PECOS PAC ID: 0749623536 Enrollment ID: I20240227000681 |
| Provider Name | Dana Grisham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659147155 PECOS PAC ID: 0941645162 Enrollment ID: I20240228000169 |
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