Active NPI
Michael W Phillips, LIMHP
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1245393461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LIMHP 794
- Practice address
- 4102 Woolworth Ave
Omaha, NE 68105-1899 - Phone
- (402) 444-7608
- Fax
- (402) 996-8171
- NPI assigned
- Dec 18, 2006
- Last updated
- Dec 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LMHP1482 | NE | |
| Mental Health Counselor | 101YM0800X | LIMHP 794 | NE | Primary |
| Professional Counselor | 101YP2500X | 938 | NE |
Addresses
Primary practice location
4102 Woolworth Ave
Omaha, NE 68105-1899
Mailing address
4102 Woolworth Ave
Omaha, NE 68105-1899
Phone (402) 444-7608
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84975 | Other | NE | BCBS |
| 47037661286 | Medicaid | NE | |
| 10025315700 | Other | NE | MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LIMHP 794 | NE | MD | Mental Health Counselor |
| LMHP1482 | NE | MD | Mental Health Counselor |
| 938 | NE | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481846400000",
"number": "1245393461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051899",
"telephone_number": "402-444-7608",
"fax_number": "402-996-8171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051899",
"telephone_number": "402-444-7608",
"fax_number": "402-996-8171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MICHAEL",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "LIMHP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2016-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "LMHP1482",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "LIMHP 794",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "938",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "84975",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47037661286",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "10025315700",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.