Provider Demographics
NPI:1811086689
Name:MESSELHEISER, DEAN LYNN (MSW)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:LYNN
Last Name:MESSELHEISER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 HENERY CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2344
Mailing Address - Country:US
Mailing Address - Phone:402-884-8761
Mailing Address - Fax:
Practice Address - Street 1:901 SAC BLVD STE 2D7
Practice Address - Street 2:
Practice Address - City:OFFUTT AFB
Practice Address - State:NE
Practice Address - Zip Code:68113-5455
Practice Address - Country:US
Practice Address - Phone:402-294-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00419OtherSOCIAL WORK LICENSE