Provider Demographics
NPI:1649983545
Name:HOLISTIC HEALING COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:HOLISTIC HEALING COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEZI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCEVOY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:308-360-2444
Mailing Address - Street 1:5700 S 96TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9753
Mailing Address - Country:US
Mailing Address - Phone:308-360-2444
Mailing Address - Fax:
Practice Address - Street 1:4344 N 62ND ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68507-1215
Practice Address - Country:US
Practice Address - Phone:308-360-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)