Samuel Crouch | |
115 W Railway St Ste A102 Scottsbluff NE 69361-3180 | |
(308) 225-0500 | |
(308) 365-6848 |
Full Name | Samuel Crouch |
---|---|
Speciality | Counselor - Mental Health |
Location | 115 W Railway St Ste A102, Scottsbluff, Nebraska |
Authorized Official Name and Position | Samuel Crouch (OWNER) |
Authorized Official Contact | 3082250500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Samuel Crouch 115 W Railway St Ste A102 Scottsbluff NE 69361-3180 Ph: (308) 225-0500 | Samuel Crouch 115 W Railway St Ste A102 Scottsbluff NE 69361-3180 Ph: (308) 225-0500 |
NPI Number | 1215402151 |
---|---|
Provider Enumeration Date | 10/08/2018 |
Last Update Date | 01/08/2024 |
Certification Date | 01/08/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215402151 | NPI | - | NPPES |
53611285605 | Medicaid | NE | |
10026769300 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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› Verified 6 days ago
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