Healthcare Provider Details

I. General information

NPI: 1326036492
Provider Name (Legal Business Name): DAVE MIERS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S 16TH ST SUITE 330
LINCOLN NE
68502-3796
US

IV. Provider business mailing address

2222 S 16TH ST SUITE 330
LINCOLN NE
68502-3796
US

V. Phone/Fax

Practice location:
  • Phone: 402-474-1511
  • Fax: 402-474-1611
Mailing address:
  • Phone: 402-474-1511
  • Fax: 402-474-1611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1475
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number593
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number935
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: