| Wholeness Healing Center Pc | |
|
2608 Old Fair Rd Grand Island NE 68803-5271 | |
| (308) 382-5297 | |
| (308) 382-5315 |
| Full Name | Wholeness Healing Center Pc |
|---|---|
| Speciality | Counselor |
| Location | 2608 Old Fair Rd, Grand Island, Nebraska |
| Authorized Official Name and Position | Jane L Watson (OWNER, DIRECTOR) |
| Authorized Official Contact | 3083825297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wholeness Healing Center Pc 2608 Old Fair Rd Grand Island NE 68803-5271 Ph: (308) 382-5297 | Wholeness Healing Center Pc 2608 Old Fair Rd Grand Island NE 68803-5271 Ph: (308) 382-5297 |
| NPI Number | 1124130364 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/16/2023 |
| Medicare PECOS PAC ID | 3173571320 |
|---|---|
| Medicare Enrollment ID | O20050105000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124130364 | NPI | - | NPPES |
| 10025173200 | Medicaid | NE | |
| 10025173100 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jane L Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770688657 PECOS PAC ID: 6305829268 Enrollment ID: I20040611000033 |
| Provider Name | Jody A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760680797 PECOS PAC ID: 6204937584 Enrollment ID: I20070731000418 |
| Provider Name | Josephine K Studnicka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851684450 PECOS PAC ID: 0143498410 Enrollment ID: I20110713000259 |
| Provider Name | Nadine J Stuehm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912307083 PECOS PAC ID: 4385953074 Enrollment ID: I20151020001743 |
| Provider Name | Erica J Hardessen Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477955813 PECOS PAC ID: 2365732724 Enrollment ID: I20160526001609 |
| Provider Name | Michelle Diane Stoller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043680622 PECOS PAC ID: 1153682794 Enrollment ID: I20180223000124 |
| Provider Name | Riley Jean Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730725201 PECOS PAC ID: 5799118741 Enrollment ID: I20191204002134 |
| Provider Name | Elizabeth Ann Todd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740764372 PECOS PAC ID: 0244661221 Enrollment ID: I20200506002196 |
| Provider Name | Ruth M Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760019467 PECOS PAC ID: 2769801026 Enrollment ID: I20201006001548 |
| Provider Name | Jessica C Kingsley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528372166 PECOS PAC ID: 1254570302 Enrollment ID: I20201022000246 |
| Provider Name | Jody L Detwieler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962622746 PECOS PAC ID: 6800204942 Enrollment ID: I20210409001058 |
| Provider Name | Valerie Joy Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386271419 PECOS PAC ID: 9032549076 Enrollment ID: I20210908002161 |
| Provider Name | Christina Danielle Larsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568036390 PECOS PAC ID: 4486003415 Enrollment ID: I20231215000577 |
| Provider Name | Dorothy Ruth Molczyk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942362546 PECOS PAC ID: 1951750918 Enrollment ID: I20231215001884 |
| Provider Name | Melanie Grace Gabbert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235277039 PECOS PAC ID: 9234588120 Enrollment ID: I20231218003554 |
| Provider Name | Carolyn Diane Haney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871756965 PECOS PAC ID: 3678918398 Enrollment ID: I20240304001590 |
| Provider Name | Kali Adell Almond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528713021 PECOS PAC ID: 3072955236 Enrollment ID: I20240521000372 |
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