Provider Demographics
NPI:1295153815
Name:GOLD CIRCLE COUNSELING LLC
Entity type:Organization
Organization Name:GOLD CIRCLE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:H
Authorized Official - Last Name:CYR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-333-6950
Mailing Address - Street 1:13911 GOLD CIR
Mailing Address - Street 2:SUITE #210
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2378
Mailing Address - Country:US
Mailing Address - Phone:402-333-6950
Mailing Address - Fax:402-333-6944
Practice Address - Street 1:13911 GOLD CIR
Practice Address - Street 2:SUITE #210
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2378
Practice Address - Country:US
Practice Address - Phone:402-333-6950
Practice Address - Fax:402-333-6944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty