Provider Demographics
NPI:1235479072
Name:MUGGY, TYNE MICHELLE (MA LMHP)
Entity Type:Individual
Prefix:MS
First Name:TYNE
Middle Name:MICHELLE
Last Name:MUGGY
Suffix:
Gender:F
Credentials:MA LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4600 VALLEY ROAD
Mailing Address - Street 2:STE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4882
Mailing Address - Country:US
Mailing Address - Phone:402-483-4571
Mailing Address - Fax:402-483-5633
Practice Address - Street 1:4600 VALLEY ROAD
Practice Address - Street 2:STE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4882
Practice Address - Country:US
Practice Address - Phone:402-483-4571
Practice Address - Fax:402-483-5633
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470553011-01Medicaid
NE470398819Medicaid