Individual provider Active NPI

Melissa D Brestel, LIMHP, LCSW

  • Mental Health Counselor
  • Papillion, NE
National Provider Identifier
1164597506
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
804 Issued in NE
Practice address
1410 E Gold Coast Rd Ste 800
Papillion, NE 68046-5794
Phone
(402) 557-6027
Fax
(402) 557-6028
NPI assigned
Nov 21, 2006
Last updated
Aug 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1320 NE
Mental Health Counselor 101YM0800X 804 NE Primary

Addresses

Primary practice location

1410 E Gold Coast Rd Ste 800
Papillion, NE 68046-5794

Mailing address

1410 E Gold Coast Rd Ste 800
Papillion, NE 68046-5794
Phone (402) 557-6027

Other names 1

  • Melissa D Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100421000717 NE Practitioner - Clinical Social Worker 0042347130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Resource Associates IncGroup PAC ID 8729971049, 8 clinicians

Practice addresses (Care Compare)

10824 Old Mill Rd
Suite 21
Omaha, NE 68154-2642
Phone (402) 330-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
804NEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Resource Associates, Inc. Mental Health CurrentSince Nov 15, 2020 Accepting new patients
Forensic Behavioral Health, Inc. CurrentSince Jul 27, 2012 Accepting new patients

Locations

10824 Old Mill Rd
Ste 21
Omaha, NE 68154
Phone (402) 330-6060

1410 E Gold Coast Rd
Ste 300
Papillion, NE 68046
Phone (402) 557-6027

1410 E Gold Coast Rd
Ste 800
Papillion, NE 68046
Phone (402) 557-6027

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1164597506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E GOLD COAST RD STE 800",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680465794",
            "telephone_number": "402-557-6027",
            "fax_number": "402-557-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E GOLD COAST RD STE 800",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680465794",
            "telephone_number": "402-557-6027",
            "fax_number": "402-557-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESTEL",
        "first_name": "MELISSA",
        "middle_name": "D",
        "credential": "LIMHP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1320",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MILLER",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

Verify at the official NPI Registry.