Organization
CARISSA ELLIOTT AND MICHAEL LEACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARISSA ELLIOTT (PARTNER)
(308) 430-4273
Entity
Organization
Contact information
Practice address
127 W 2ND ST STE 201, CHADRON, NE 69337-2883
(308) 430-4273
Mailing address
522 N MOREHEAD ST, CHADRON, NE 69337-2135
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3671
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026164200
—
NE
Enumeration date
10/11/2016
Last updated
10/11/2016
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