Organization
CENTER CREEK COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHASTITY ANN INGRAM (OWNER/PROVIDER)
(308) 470-1338
Entity
Organization
Contact information
Practice address
775 31 RD, FRANKLIN, NE 68939-5158
(308) 470-1338
(308) 425-3167
Mailing address
775 31 RD, FRANKLIN, NE 68939-5158
(308) 470-1338
(308) 425-3167
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1342
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025916400
—
NE
05
—
10025916700
—
NE
05
—
200433160F
—
KS
01
—
NA1760
MEDICARE PTAN
—
Enumeration date
06/02/2014
Last updated
10/12/2015
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