| Liberated Path Llc | |
|
612 Pennsylvania St Table Rock NE 68447-3014 | |
| (402) 852-8203 | |
| Not Available |
| Full Name | Liberated Path Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 612 Pennsylvania St, Table Rock, Nebraska |
| Authorized Official Name and Position | Laura Poskochil (OWNER/THERAPIST) |
| Authorized Official Contact | 4028528203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberated Path Llc 612 Pennsylvania St Table Rock NE 68447-3014 Ph: (512) 609-9027 | Liberated Path Llc 612 Pennsylvania St Table Rock NE 68447-3014 Ph: (402) 852-8203 |
| NPI Number | 1033901046 |
|---|---|
| Provider Enumeration Date | 05/19/2025 |
| Last Update Date | 05/19/2025 |
| Certification Date | 05/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033901046 | NPI | - | NPPES |
| 1689483810 | Other | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |