Organization
PRAIRIE PSYCHOLOGICAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TWILA L PRESTON PHD (OWNER)
(402) 494-0040
Entity
Organization
Contact information
Practice address
625 E 39TH ST, SOUTH SIOUX CITY, NE 68776-3445
(402) 494-0040
(402) 494-0050
Mailing address
625 E 39TH ST, SOUTH SIOUX CITY, NE 68776-3445
(402) 494-0040
(402) 494-0050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
371
NE
101YP2500X
Professional Counselor
1187
NE
101YP2500X
Professional Counselor
1729
NE
103TC0700X
Clinical Psychologist
Primary
531
NE
1041C0700X
Clinical Social Worker
808
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025015800
—
NE
Enumeration date
08/22/2005
Last updated
07/30/2013
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