Organization
FAMILY NETWORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY JO SHADA LMHP (OWNER)
(308) 236-7545
Entity
Organization
Contact information
Practice address
415 W 33RD ST, KEARNEY, NE 68845-3460
(308) 236-7545
Mailing address
415 W 33RD ST, KEARNEY, NE 68845-3460
(308) 236-7545
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
423
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025506300
—
NE
Enumeration date
12/13/2016
Last updated
12/13/2016
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