| Inspiring Change Llc | |
|
128 S 17th St Blair NE 68008-2004 | |
| (402) 304-9229 | |
| Not Available |
| Full Name | Inspiring Change Llc |
|---|---|
| Speciality | Counselor |
| Location | 128 S 17th St, Blair, Nebraska |
| Authorized Official Name and Position | Amy Douglas (OWNER) |
| Authorized Official Contact | 4023049229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspiring Change Llc 128 S 17th St Blair NE 68008-2004 Ph: (402) 304-9229 | Inspiring Change Llc 128 S 17th St Blair NE 68008-2004 Ph: (402) 304-9229 |
| NPI Number | 1023504164 |
|---|---|
| Provider Enumeration Date | 07/01/2018 |
| Last Update Date | 10/25/2019 |
| Medicare PECOS PAC ID | 6305297367 |
|---|---|
| Medicare Enrollment ID | O20240104000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023504164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Amy Douglas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942795125 PECOS PAC ID: 0547543951 Enrollment ID: I20240104000899 |
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