Individual provider Active NPI

Kelly Micek, PLMHP

  • Mental Health Counselor
  • Elkhorn, NE
National Provider Identifier
1740646157
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10767 Issued in NE
Practice address
20275 Honeysuckle Dr
Ste 103
Elkhorn, NE 68022-3962
Phone
(402) 933-5700
Fax
(402) 933-9998
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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 10767 NE Primary

Addresses

Primary practice location

20275 Honeysuckle Dr
Ste 103
Elkhorn, NE 68022-3962

Mailing address

20275 Honeysuckle Dr
Ste 103
Elkhorn, NE 68022-3962
Phone (402) 933-5700

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
10767NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Empowering Minds Behavioral Health Mental Health Current Accepting new patients
Exhale Behavioral Health LLC Current Accepting new patients

Locations

610 J St
Ste 110
Lincoln, NE 68508
Phone (402) 560-0971

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": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1740646157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20275 HONEYSUCKLE DR",
            "address_2": "STE 103",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223962",
            "telephone_number": "402-933-5700",
            "fax_number": "402-933-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20275 HONEYSUCKLE DR",
            "address_2": "STE 103",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223962",
            "telephone_number": "402-933-5700",
            "fax_number": "402-933-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICEK",
        "first_name": "KELLY",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.

Verify at the official NPI Registry.