Provider Demographics
NPI:1568829661
Name:PARSHA, MYISHA
Entity type:Individual
Prefix:
First Name:MYISHA
Middle Name:
Last Name:PARSHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S 42ND ST
Mailing Address - Street 2:SUITE 328
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2939
Mailing Address - Country:US
Mailing Address - Phone:402-614-8444
Mailing Address - Fax:402-614-8443
Practice Address - Street 1:5410 S 99TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3214
Practice Address - Country:US
Practice Address - Phone:531-444-1963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10772101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health