Provider Demographics
NPI:1982902441
Name:JEWELL COUNSELING SERVICES
Entity type:Organization
Organization Name:JEWELL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:402-672-3333
Mailing Address - Street 1:12512 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-1430
Mailing Address - Country:US
Mailing Address - Phone:402-672-3333
Mailing Address - Fax:
Practice Address - Street 1:12512 CRAWFORD RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-1430
Practice Address - Country:US
Practice Address - Phone:402-672-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3065101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3065OtherNEBRASKA LICENSE #