Individual provider Active NPI

Miguel Angel Estevez Jr., PLMHP, PLADC

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1336770049
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12119 Issued in NE
Practice address
707 W 1St St
Grand Island, NE 68801-5805
Phone
(308) 675-3345
NPI assigned
Jan 31, 2020
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X P-1758 NE
Mental Health Counselor 101YM0800X 12119 NE Primary

Addresses

Primary practice location

707 W 1St St
Grand Island, NE 68801-5805

Mailing address

707 W 1St St
Grand Island, NE 68801-5805
Phone (308) 675-3345

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

LicenseStateTypeSpecialty
P-1758NEMDAddiction (Substance Use Disorder) Counselor
12119NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Friendship House, Inc. Multi-Specialty CurrentSince Jul 1, 2024 Accepting new patients
Friendship House, Inc. PastSince Feb 2, 2020 Accepting new patients

Locations

707 W 1st St
Grand Island, NE 68801
Phone (308) 382-0422

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1336770049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W 1ST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015805",
            "telephone_number": "308-675-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 1ST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015805",
            "telephone_number": "308-675-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEVEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "name_suffix": "Jr.",
        "credential": "PLMHP, PLADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-1758",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.