Individual provider Active NPI

Michaella Ruth Dunn, LMHP

  • Clinical Social Worker
  • Council Bluffs, IA
National Provider Identifier
1255669909
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008039 Issued in IA
Practice address
300 W Broadway Ste 270
Council Bluffs, IA 51503-9028
Phone
(402) 397-9866
Fax
(402) 397-1404
NPI assigned
Nov 18, 2009
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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 9016 NE
Clinical Social Worker 1041C0700X 008039 IA Primary

Addresses

Primary practice location

300 W Broadway Ste 270
Council Bluffs, IA 51503-9028

Mailing address

4328 Marcy St
Omaha, NE 68105-1038
Phone (402) 917-2629

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1255669909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 MARCY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051038",
            "telephone_number": "402-917-2629",
            "fax_number": "712-256-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY STE 270",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039028",
            "telephone_number": "402-397-9866",
            "fax_number": "402-397-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "MICHAELLA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "LMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "9016",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.