| Professional Mental Health Services, L.l.c. | |
|
3314 26th St Suite D Columbus NE 68601-2304 | |
| (402) 562-7099 | |
| Not Available |
| Full Name | Professional Mental Health Services, L.l.c. |
|---|---|
| Speciality | Counselor |
| Location | 3314 26th St, Columbus, Nebraska |
| Authorized Official Name and Position | Jolaine Lynn Edwards (MANAGER) |
| Authorized Official Contact | 4025627099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Mental Health Services, L.l.c. 5 Robin Ln Columbus NE 68601-6200 Ph: (402) 562-7099 | Professional Mental Health Services, L.l.c. 3314 26th St Suite D Columbus NE 68601-2304 Ph: (402) 562-7099 |
| NPI Number | 1356517858 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 05/05/2008 |
| Medicare PECOS PAC ID | 3577636547 |
|---|---|
| Medicare Enrollment ID | O20080724000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356517858 | NPI | - | NPPES |
| 10025626600 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1541 (Nebraska) | Primary |
| Provider Name | Jolaine L Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275639049 PECOS PAC ID: 6305919374 Enrollment ID: I20080724000047 |
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