MEDICARE: DR. DAVE MIERS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1475	NE
2	101YM0800X	Mental Health Counselor	593	NE
3	101YP2500X	Professional Counselor	935	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326036492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVE MIERS PHD

Provider Business Mailing Address
First Line	:	2222 S 16TH ST
Second Line	:	SUITE 330
City	:	LINCOLN
State	:	NE
Zip	:	68502-3796
Country	:	US
Telephone Number	:	402-474-1511
Fax Number	:	402-474-1611

Provider Business Practice Location Address
First Line	:	2222 S 16TH ST
Second Line	:	SUITE 330
City	:	LINCOLN
State	:	NE
Zip	:	68502-3796
Country	:	US
Telephone Number	:	402-474-1511
Fax Number	:	402-474-1611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	12/16/2011

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Directions to “ DR. DAVE MIERS PHD” Practice Location

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