Provider Demographics
NPI:1154693596
Name:MICHELE MISSEL COUNSELING
Entity type:Organization
Organization Name:MICHELE MISSEL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LCSW
Authorized Official - Phone:402-719-1778
Mailing Address - Street 1:427 N BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-5435
Mailing Address - Country:US
Mailing Address - Phone:402-721-0591
Mailing Address - Fax:
Practice Address - Street 1:437 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-6049
Practice Address - Country:US
Practice Address - Phone:402-719-1778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty