| Wishing Well Counseling Llc | |
|
4444 S 86th St St. Suite 102 Lincoln NE 68526-9253 | |
| (402) 476-7557 | |
| (402) 476-9912 |
| Full Name | Wishing Well Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 4444 S 86th St St., Lincoln, Nebraska |
| Authorized Official Name and Position | Becky Haumont (OFFICE MANAGER) |
| Authorized Official Contact | 4024767557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wishing Well Counseling Llc 4444 S 86th St St. Suite 102 Lincoln NE 68526-9253 Ph: (402) 476-7557 | Wishing Well Counseling Llc 4444 S 86th St St. Suite 102 Lincoln NE 68526-9253 Ph: (402) 476-7557 |
| NPI Number | 1154959187 |
|---|---|
| Provider Enumeration Date | 03/27/2020 |
| Last Update Date | 09/26/2023 |
| Certification Date | 03/27/2020 |
| Medicare PECOS PAC ID | 4183168263 |
|---|---|
| Medicare Enrollment ID | O20240701000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154959187 | NPI | - | NPPES |
| 60096287201 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Cassandra Lee Munger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346634672 PECOS PAC ID: 5092259176 Enrollment ID: I20240701000426 |
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