Provider Demographics
NPI:1396880548
Name:MILLER, MICHELLE B (LIMHP, LMHP LPC CPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:MILLER
Suffix:
Gender:F
Credentials:LIMHP, LMHP LPC CPC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:B
Other - Last Name:LUEBCKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP, LPC
Mailing Address - Street 1:331 INDIAN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2604
Mailing Address - Country:US
Mailing Address - Phone:402-450-5288
Mailing Address - Fax:
Practice Address - Street 1:7121 A STREET
Practice Address - Street 2:STE. 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4289
Practice Address - Country:US
Practice Address - Phone:402-805-4400
Practice Address - Fax:402-805-4403
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2930101YM0800X
NE1522101YP2500X
NELIMHP#879101YM0800X
NELMHP#2930101YM0800X
NELPC#1522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE714647000OtherMIS NUMBER
NE10025337300Medicaid
NE870757429Medicare UPIN