Provider Demographics
NPI:1295749869
Name:JEWELL, MICHELLE M (LMHP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:M
Last Name:JEWELL
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11329 P ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2315
Mailing Address - Country:US
Mailing Address - Phone:402-597-2350
Mailing Address - Fax:402-597-2351
Practice Address - Street 1:11329 P ST
Practice Address - Street 2:SUITE 105
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2315
Practice Address - Country:US
Practice Address - Phone:402-597-2350
Practice Address - Fax:402-597-2351
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3065101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor