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General NPI Number Information
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NPI Number | 1962668491
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH CARE ASSOC
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 343 CHADRON AVE
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City | CHADRON
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State | NE
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Zip | 69337
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Country | US
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Telephone | 308-432-2133
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Fax | 308-432-2133
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Provider Business Mailing Address
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Address Line | 343 CHADRON AVE
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City | CHADRON
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State | NE
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Zip | 69337
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Country | US
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Telephone | 308-432-2133
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Fax | 308-432-2133
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Authorized Official
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Title or Position | OWNER
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Name | DR. LORRAINE I MILES
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Credential | PHD
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Telephone | 308-432-2133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 412
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 38
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 378
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License Number State | NE
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