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Organization

COMPASS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALISA JO RYAN LMHP (CLINICAL DIRECTOR)
(308) 237-4085
Entity
Organization

Contact information

Practice address
514 W 11TH ST, KEARNEY, NE 68845-7336
(308) 237-4085
(308) 224-3864
Mailing address
514 W 11TH ST, KEARNEY, NE 68845-7336
(308) 237-4085
(308) 224-3864

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026876900
NE
Enumeration date
04/22/2021
Last updated
07/09/2025
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