Provider Demographics
NPI:1982935045
Name:FLOYD, MICHAEL BURTON
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BURTON
Last Name:FLOYD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 S 17TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3750
Mailing Address - Country:US
Mailing Address - Phone:402-476-0104
Mailing Address - Fax:402-438-2801
Practice Address - Street 1:2130 S 17TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3750
Practice Address - Country:US
Practice Address - Phone:402-476-0104
Practice Address - Fax:402-438-2801
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE511101YA0400X
NE2368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)