Individual provider Active NPI

Michelle Irene Fitzgibbon, LCSW, LMHP

  • Social Worker
  • Elkhorn, NE
National Provider Identifier
1891587846
Registry record updated May 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1510 Issued in NE
Practice address
20861 S PLZ
Elkhorn, NE 68022-4448
Phone
(308) 379-8750
NPI assigned
May 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1510 NE Primary

Addresses

Primary practice location

20861 S PLZ
Elkhorn, NE 68022-4448

Mailing address

20861 S PLZ
Elkhorn, NE 68022-4448
Phone (308) 379-8750

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
1510NEMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1747440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747440000000",
    "number": "1891587846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20861 S PLZ",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224448",
            "telephone_number": "308-379-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20861 S PLZ",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224448",
            "telephone_number": "308-379-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBON",
        "first_name": "MICHELLE",
        "middle_name": "IRENE",
        "credential": "LCSW, LMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-17",
        "last_updated": "2025-05-17",
        "certification_date": "2025-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NE",
            "license": "1510",
            "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 May 17, 2025; 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.