| Kerry L Alfrey Llc | |
|
403 Lexington Cir Grand Island NE 68803-9728 | |
| (308) 675-2858 | |
| (308) 675-2874 |
| Full Name | Kerry L Alfrey Llc |
|---|---|
| Speciality | Counselor |
| Location | 403 Lexington Cir, Grand Island, Nebraska |
| Authorized Official Name and Position | Kerry Alfrey (OWNER) |
| Authorized Official Contact | 3086752858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kerry L Alfrey Llc 403 Lexington Cir Grand Island NE 68803-9728 Ph: (308) 675-2858 | Kerry L Alfrey Llc 403 Lexington Cir Grand Island NE 68803-9728 Ph: (308) 675-2858 |
| NPI Number | 1578276564 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 04/02/2025 |
| Certification Date | 03/24/2025 |
| Medicare PECOS PAC ID | 5698291623 |
|---|---|
| Medicare Enrollment ID | O20250502000377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578276564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Vanessa Pruitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740858943 PECOS PAC ID: 5496271421 Enrollment ID: I20250502000428 |
| Provider Name | Kerry L Alfrey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194004762 PECOS PAC ID: 8224554258 Enrollment ID: I20250502000481 |
| Provider Name | Amanda Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902501067 PECOS PAC ID: 9032653019 Enrollment ID: I20250502000642 |
| Provider Name | Mary C. Rock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265527139 PECOS PAC ID: 9931628096 Enrollment ID: I20250522000528 |
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