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NPI Code Detail

MEDICARE: MR. MICHEAL MILES POP L.M.H.P.

MEDICARE:  MR. MICHEAL MILES POP  L.M.H.P.
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
1101YM0800XMental Health Counselor1303NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
285614OTHERNEBLUE CROSS BLUE SHIELD NE
3808338000OTHERNEMAGELLAN -USER NAME

General Provider Information

NPI Number : 1881772341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHEAL MILES POP L.M.H.P.
Provider Business Mailing Address
First Line : PO BOX 333
Second Line :
City : LOUP CITY
State : NE
Zip : 68853-0333
Country : US
Telephone Number : 308-745-0329
Fax Number : 308-745-0329
Provider Business Practice Location Address
First Line : 329 J ST
Second Line :
City : LOUP CITY
State : NE
Zip : 68853-8118
Country : US
Telephone Number : 308-745-0329
Fax Number : 308-745-0329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ MR. MICHEAL MILES POP L.M.H.P.” Practice Location

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