Provider Demographics
NPI:1760850002
Name:MEUSCH, MICHELE R (MS, LADC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:MEUSCH
Suffix:
Gender:F
Credentials:MS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:NE
Mailing Address - Zip Code:68780-0001
Mailing Address - Country:US
Mailing Address - Phone:402-658-0164
Mailing Address - Fax:
Practice Address - Street 1:102 EAST HWY 20
Practice Address - Street 2:SUITE 2
Practice Address - City:STUART
Practice Address - State:NE
Practice Address - Zip Code:68780
Practice Address - Country:US
Practice Address - Phone:402-658-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1027101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)