Michelle Pruneda Raburn, CSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

3124 Issued in NE

Practice address

601 Norris Ave
MC Cook, NE 69001-3140

Phone

(308) 345-4067

Fax

(308) 345-3067

NPI assigned

Jul 19, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Michelle Pruneda Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Ambience Counseling Center, LLC

  • Community/Behavioral Health Agency
  • MC Cook, NE
  • NPI 1174704589

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1346975737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NORRIS AVE",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013140",
            "telephone_number": "308-345-4067",
            "fax_number": "308-345-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NORRIS AVE",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013140",
            "telephone_number": "308-345-4067",
            "fax_number": "308-345-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABURN",
        "first_name": "MICHELLE",
        "middle_name": "PRUNEDA",
        "name_prefix": "Ms.",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NE",
            "license": "3124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Email",
            "affiliation": "N",
            "endpointDescription": "Shared Information",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Description",
            "address_1": "601 Norris Ave",
            "city": "Mc Cook",
            "state": "NE",
            "country_code": "US",
            "postal_code": "690013140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "PRUNEDA",
            "prefix": "MISS",
            "credential": "CSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in MC Cook, NE
• Providers in MC Cook, NE by specialty
• Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.