Provider Demographics
NPI:1174644074
Name:MORGANFLASH, MICHELLE MARIE (LIMHP)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:MARIE
Last Name:MORGANFLASH
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 N SAUNDERS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3814
Mailing Address - Country:US
Mailing Address - Phone:402-463-4393
Mailing Address - Fax:
Practice Address - Street 1:223 E. 14TH STREET
Practice Address - Street 2:SUITE 45
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3257
Practice Address - Country:US
Practice Address - Phone:402-462-4004
Practice Address - Fax:402-462-4005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE813101YM0800X
NE3427101YM0800X
NE1730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025469800Medicaid