NPIMap

Organization Active NPI

Good Life Counseling & Support LLC

  • Mental Health Counselor
  • Norfolk, NE
National Provider Identifier
1720191570
Registry record updated Dec 31, 2024
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
200 North 34TH Street
Norfolk, NE 68702-2315
Phone
(402) 371-3044
Fax
(402) 371-9643
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Mrs. Laurie A Millard, LMHP CPC
Title
Program Director
Phone
(402) 371-3044

Specialties & licenses 1

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

Addresses

Primary practice location

200 North 34TH Street
Norfolk, NE 68702-2315

Mailing address

200 North 34TH Street
PO Box 2315
Norfolk, NE 68702-2315
Phone (402) 371-3044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408000006 NE Part B Supplier - Clinic/Group Practice 0446243042 Receives reassigned benefits from 6 practitioners
Practice locations: Columbus, NE; Norfolk, NE

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

2277 22nd Ave
Columbus, NE 68601
Phone (402) 562-0400

200 N 34th St
Norfolk, NE 68701
Phone (402) 371-3044

122 S 4th St
Oneill, NE 68763
Phone (402) 336-2136

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1720191570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTH 34TH STREET",
            "address_2": "PO BOX 2315",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687022315",
            "telephone_number": "402-371-3044",
            "fax_number": "402-371-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH 34TH STREET",
            "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": "2006-08-16",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "MILLARD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "402-371-3044",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHP CPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.