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Organization

LINCOLN KARATE CLINIC, INC.

Active
Other names
KICKS Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT DAVID WALLS MA, LIPC, CCMHC (OWNER/PRESIDENT)
(402) 430-6912
Entity
Organization

Contact information

Practice address
237 S 70TH ST, SUITE: 108, LINCOLN, NE 68510-2473
(402) 430-6912
Mailing address
237 S 70TH ST, SUITE: 108, LINCOLN, NE 68510-2473
(402) 430-6912

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
244
NE

Other

Enumeration date
04/28/2016
Last updated
04/28/2016
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