Healthcare Provider Details

I. General information

NPI: 1083011241
Provider Name (Legal Business Name): MICAELA VANSKIVER WILLIAMS PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8922 CUMING ST
OMAHA NE
68114-2732
US

IV. Provider business mailing address

20275 HONEYSUCKLE DR STE 103
ELKHORN NE
68022-3962
US

V. Phone/Fax

Practice location:
  • Phone: 402-926-4373
  • Fax: 402-926-3898
Mailing address:
  • Phone: 402-933-5700
  • Fax: 402-933-9998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1682
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2680
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: