Provider Demographics
NPI:1326036492
Name:MIERS, DAVE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVE
Middle Name:
Last Name:MIERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S 16TH ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3796
Mailing Address - Country:US
Mailing Address - Phone:402-474-1511
Mailing Address - Fax:402-474-1611
Practice Address - Street 1:2222 S 16TH ST
Practice Address - Street 2:SUITE 330
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3796
Practice Address - Country:US
Practice Address - Phone:402-474-1511
Practice Address - Fax:402-474-1611
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1475101YM0800X
NE593101YM0800X
NE935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47069-842-826Medicaid