Individual provider Active NPI

Michelle Anne Melroy, IMHP, MA

  • Mental Health Counselor
  • La Vista, NE
National Provider Identifier
1700035409
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
932 Issued in NE
Practice address
12110 Port Grace Blvd Ste 101
La Vista, NE 68128-3190
Phone
(402) 645-0038
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 932 NE Primary

Addresses

Primary practice location

12110 Port Grace Blvd Ste 101
La Vista, NE 68128-3190

Mailing address

7329 S 184TH Ave
Omaha, NE 68136-6554
Phone (308) 641-5243

Other practice location 1

7329 S 184th Ave
Omaha, NE 68136-6554
Phone (308) 641-5243

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
I20240724002088 NE Practitioner - Mental Health Counselor 9234675430 Practice locations: Omaha, NE

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13513 Cottner St
Omaha, NE 68137-1629
Phone (308) 641-5243

7329 S 184TH Ave
Omaha, NE 68136-6554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
932NEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forza Mental Health, LLC Mental Health Current Accepting new patients
Teladoc Health Medical Group, P.a. Counselor Current Accepting new patients

Locations

13513 Cottner St
Omaha, NE 68137
Phone (308) 641-5243

Interoperability endpoints

  • Direct secure messaging: michellemelroy@tdh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1700035409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7329 S 184TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681366554",
            "telephone_number": "308-641-5243",
            "fax_number": "531-201-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 PORT GRACE BLVD STE 101",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681283190",
            "telephone_number": "402-645-0038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7329 S 184th Ave",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681366554",
            "country_code": "US",
            "telephone_number": "308-641-5243",
            "fax_number": "531-201-0201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELROY",
        "first_name": "MICHELLE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "IMHP, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vista, NE

Sources for this page

Verify at the official NPI Registry.