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Individual

MR. MICHAEL W PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LIMHP

Contact information

Practice address
4102 WOOLWORTH AVE, OMAHA, NE 68105-1899
(402) 444-7608
(402) 996-8171
Mailing address
4102 WOOLWORTH AVE, OMAHA, NE 68105-1899
(402) 444-7608
(402) 996-8171

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LIMHP 794
NE
101YM0800X
Mental Health Counselor
LMHP1482
NE
101YP2500X
Professional Counselor
938
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10025315700
MEDICAID
NE
05
47037661286
NE
01
84975
BCBS
NE
Enumeration date
12/18/2006
Last updated
12/16/2016
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