| Vanessa Buttery Professional Counseling Services Llc | |
|
1055 N 115th St Ste 105 Omaha NE 68154-4419 | |
| (402) 960-5287 | |
| Not Available |
| Full Name | Vanessa Buttery Professional Counseling Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1055 N 115th St Ste 105, Omaha, Nebraska |
| Authorized Official Name and Position | Vanessa Buttery (OWNER) |
| Authorized Official Contact | 4029605287 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanessa Buttery Professional Counseling Services Llc Po Box 641422 Omaha NE 68164-7422 Ph: (402) 960-5287 | Vanessa Buttery Professional Counseling Services Llc 1055 N 115th St Ste 105 Omaha NE 68154-4419 Ph: (402) 960-5287 |
| NPI Number | 1639950827 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 10/25/2023 |
| Certification Date | 10/25/2023 |
| Medicare PECOS PAC ID | 7113360447 |
|---|---|
| Medicare Enrollment ID | O20240202003813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639950827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Vanessa Irene Buttery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174002026 PECOS PAC ID: 8022451350 Enrollment ID: I20240202003833 |
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