Organization
PRAIRIE HOPE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY DIERKSEN MSW, LCSW, PADC, RN (SOLE PROPRIETER)
(308) 430-1023
Entity
Organization
Contact information
Practice address
810 LONG RD, HAY SPRINGS, NE 69347-2504
(308) 638-4411
(308) 432-4003
Mailing address
810 LONG RD, HAY SPRINGS, NE 69347-2504
(308) 638-4411
(308) 432-4003
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
004011365749
NE
Other
Enumeration date
11/06/2012
Last updated
12/31/2014
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