Healthcare Provider Details

I. General information

NPI: 1073049300
Provider Name (Legal Business Name): MICHAEL ELLAND LIMHP, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W BROADWAY STE 240
COUNCIL BLUFFS IA
51503-9028
US

IV. Provider business mailing address

1804 PARKWILD DR APT 10
COUNCIL BLUFFS IA
51503-1867
US

V. Phone/Fax

Practice location:
  • Phone: 712-310-8464
  • Fax:
Mailing address:
  • Phone: 712-310-8464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3175
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: