Provider Demographics
NPI:1063752863
Name:RELIABLE ROCK COUNSELING AND CONSULTING, P.C
Entity type:Organization
Organization Name:RELIABLE ROCK COUNSELING AND CONSULTING, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUROCK
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:402-214-6949
Mailing Address - Street 1:4060 VINTON ST
Mailing Address - Street 2:100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-3862
Mailing Address - Country:US
Mailing Address - Phone:402-214-6949
Mailing Address - Fax:
Practice Address - Street 1:4060 VINTON ST
Practice Address - Street 2:100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-3862
Practice Address - Country:US
Practice Address - Phone:402-214-6949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3460101YM0800X
NE8181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty