Provider Demographics
NPI:1316233976
Name:WILLIAMSON, MICHAEL DEAN (MSE, LIMHP, LPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DEAN
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:MSE, LIMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86314 508TH AVE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD
Mailing Address - State:NE
Mailing Address - Zip Code:68764-5044
Mailing Address - Country:US
Mailing Address - Phone:402-336-7172
Mailing Address - Fax:
Practice Address - Street 1:614 N 4TH ST STE 108
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1317
Practice Address - Country:US
Practice Address - Phone:402-336-1306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health