Provider Demographics
NPI:1073668752
Name:DUBAY, MICHELLE KRISTINE (LIMHP, LADC, PC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:KRISTINE
Last Name:DUBAY
Suffix:
Gender:F
Credentials:LIMHP, LADC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 MARIAN AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2311
Mailing Address - Country:US
Mailing Address - Phone:402-301-7518
Mailing Address - Fax:
Practice Address - Street 1:4611 SOUTH 96TH STREET # 232
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127
Practice Address - Country:US
Practice Address - Phone:402-301-7518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE656101YA0400X
NE630101YM0800X
NE1423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health