NPIMap

Organization Active NPI

Good Life Counseling & Support, LLC

  • Mental Health Counselor
  • Norfolk, NE
National Provider Identifier
1134733769
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GOOD LIFE COUNSELING & SUPPORT, LLC
Practice address
3306 Raasch Avenue
Norfolk, NE 68702-2315
Phone
(402) 371-3044
Fax
(402) 371-9643
NPI assigned
Sep 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nicky E Kettler
Title
Administrator
Phone
(402) 371-3044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3306 Raasch Avenue
Norfolk, NE 68702-2315

Mailing address

PO Box 2315
Norfolk, NE 68702-2315
Phone (402) 371-3044

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@goodlifecounseling.com Other

National Provider Directory

National Provider Directory
Tax ID family
Good Life Counseling Support LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3306 Raasch Dr
Norfolk, NE 68701
Phone (402) 371-3044

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1134733769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2315",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687022315",
            "telephone_number": "402-371-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 RAASCH AVENUE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687022315",
            "telephone_number": "402-371-3044",
            "fax_number": "402-371-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE COUNSELING & SUPPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "KETTLER",
        "authorized_official_first_name": "NICKY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-371-3044"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@goodlifecounseling.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "402-371-9643",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "3306 Raasch Avenue",
            "city": "Norfolk",
            "state": "NE",
            "country_code": "US",
            "postal_code": "687022315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.