Active NPI
Michelle Suzanne Wieme, MS, LIMHP, NCC
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1861622789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1181
- Practice address
- 12165 W Center Rd
Suite #58
Omaha, NE 68144-3962 - Phone
- (402) 661-4149
- Fax
- (402) 614-5227
- NPI assigned
- Jul 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1181 | NE | Primary |
Addresses
Primary practice location
12165 W Center Rd
Suite #58
Omaha, NE 68144-3962
Mailing address
15964 Young St
Bennington, NE 68007-1905
Phone (712) 310-7530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025994300 | Medicaid | NE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1181 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1861622789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15964 YOUNG ST",
"city": "BENNINGTON",
"state": "NE",
"postal_code": "680071905",
"telephone_number": "712-310-7530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12165 W CENTER RD",
"address_2": "SUITE #58",
"city": "OMAHA",
"state": "NE",
"postal_code": "681443962",
"telephone_number": "402-661-4149",
"fax_number": "402-614-5227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEME",
"first_name": "MICHELLE",
"middle_name": "SUZANNE",
"name_prefix": "Ms.",
"credential": "MS, LIMHP, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "1181",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025994300",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.