Individual
STACEY DAWN MICHELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHP, LIMHP, PLADC
Contact information
Practice address
942 N 13TH ST, GENEVA, NE 68361-0000
(402) 759-3802
(402) 759-3803
Mailing address
942 N 13TH ST, GENEVA, NE 68361-0000
(402) 759-3802
(402) 759-3803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
626
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-838
NE
101YM0800X
Mental Health Counselor
Primary
2802
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025618500
—
NE
05
—
47084125026
—
NE
Enumeration date
11/09/2006
Last updated
09/25/2009
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