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Individual

MR. MICHAEL DALE PELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHP

Contact information

Practice address
3600 VILLAGE DRIVE SUITE 110, LINCOLN, NE 68516-6631
(402) 875-9270
(402) 875-9272
Mailing address
5900 S 59TH ST, STE 104, LINCOLN, NE 68516
(402) 435-0557
(402) 483-6306

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2075
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10024982600
NE
05
47084125026
NE
01
82592
BCBS
NE
Enumeration date
07/13/2007
Last updated
02/15/2012
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