Provider Demographics
NPI:1366866980
Name:MILNER, SUSAN (LIMHP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MILNER
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 1:908 N HOWARD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3529
Mailing Address - Country:US
Mailing Address - Phone:308-390-3409
Mailing Address - Fax:308-398-6051
Practice Address - Street 1:908 N HOWARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3529
Practice Address - Country:US
Practice Address - Phone:308-398-6050
Practice Address - Fax:308-398-6051
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025173100Medicaid