Organization
FULCRUM COUNSELING SERVICES, LLC
Active
Other names
Samuel Crouch
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL CROUCH M.S. (OWNER)
(308) 225-0500
Entity
Organization
Contact information
Practice address
115 W RAILWAY ST STE A102, SCOTTSBLUFF, NE 69361-3180
(308) 225-0500
(308) 365-6848
Mailing address
115 W RAILWAY ST STE A102, SCOTTSBLUFF, NE 69361-3180
(308) 225-0500
(308) 365-6848
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026769300
—
NE
05
—
53611285605
—
NE
Enumeration date
10/08/2018
Last updated
01/08/2024
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