Provider Demographics
NPI:1306049424
Name:HEARTLAND COUNSELING SERVICES.INC.
Entity type:Organization
Organization Name:HEARTLAND COUNSELING SERVICES.INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LPC, ATR-BC
Authorized Official - Phone:402-494-3337
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-0355
Mailing Address - Country:US
Mailing Address - Phone:402-494-3337
Mailing Address - Fax:
Practice Address - Street 1:112 E 2ND ST
Practice Address - Street 2:STE. 115
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-2056
Practice Address - Country:US
Practice Address - Phone:402-494-3337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========27Medicaid