Provider Demographics
NPI:1093086969
Name:MICHELLE LEMKE, PC
Entity Type:Organization
Organization Name:MICHELLE LEMKE, PC
Other - Org Name:LEMKE-MICHELS PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:LEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LIMHP, LPC
Authorized Official - Phone:402-759-3802
Mailing Address - Street 1:942 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-1218
Mailing Address - Country:US
Mailing Address - Phone:402-759-3802
Mailing Address - Fax:402-759-3803
Practice Address - Street 1:942 N 13TH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-1218
Practice Address - Country:US
Practice Address - Phone:402-759-3802
Practice Address - Fax:402-759-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025618600Medicaid
NE10025852500Medicaid
NE10025816200Medicaid