Provider Demographics
NPI:1053541698
Name:FOUNDATIONS COUNSELING
Entity type:Organization
Organization Name:FOUNDATIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:RANDOLPH-ELGIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:402-366-3411
Mailing Address - Street 1:811 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STROMSBURG
Mailing Address - State:NE
Mailing Address - Zip Code:68666-3015
Mailing Address - Country:US
Mailing Address - Phone:402-366-3411
Mailing Address - Fax:402-764-4033
Practice Address - Street 1:302 E 4TH ST
Practice Address - Street 2:
Practice Address - City:STROMSBURG
Practice Address - State:NE
Practice Address - Zip Code:68666-4417
Practice Address - Country:US
Practice Address - Phone:402-366-3411
Practice Address - Fax:402-764-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health