Provider Demographics
NPI:1316955529
Name:OLD MILL COUNSELING
Entity type:Organization
Organization Name:OLD MILL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:REHOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LMHP
Authorized Official - Phone:3608-382-4495
Mailing Address - Street 1:712 W KOENIG ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-6556
Mailing Address - Country:US
Mailing Address - Phone:308-382-4495
Mailing Address - Fax:
Practice Address - Street 1:712 W KOENIG ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-6556
Practice Address - Country:US
Practice Address - Phone:308-382-4495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty