MICHELLE GODFREY, LLC


Address: 1904 South St Ste 105, Blair, NE 68008-1964
Phone: 4026770851

MICHELLE GODFREY, LLC (NPI# 1710521398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710521398
Entity Type Organization
Organization Name MICHELLE GODFREY, LLC
Practice Address 1904 South St Ste 105
Blair
NE 68008-1964
Mailing Address 8629 Peppermint Ln
Fort Calhoun
NE 68023-5259
Practice Telephone 4026770851
Mailing Telephone 4029687871
Enumeration Date 2019-11-06
Last Update Date 2019-11-06
Authorized Official Name MICHELLE MARIE GODFREY (MENTAL HEALTH THERAPIST)
Authorized Official Telephone 4029687871
Authorized Official Credential PLMHP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Office Location

Street Address 1904 SOUTH ST STE 105
City BLAIR
State NE
Zip Code 68008-1964

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NPI Name Taxonomy Address Enumeration
1235747080 Mark Allen Kwikkel Specialist/Technologist 310 N 10th, Blair, NE 68008 2020-07-17
1750752432 Mindy Logston Speech-Language Pathologist 1717 Adams Street, Blair, NE 68008 2015-10-07
1952545709 Home Care Network, Inc Nursing Care 14700 State Highway 133, Blair, NE 68008 2009-04-23
1619114246 Andrea L Ott Physician Assistant 812 N 22nd Street, Blair Clinic, Blair, NE 68008 2009-01-20
1730376047 Assisted Living Concepts Inc Assisted Living Facility 1028 Joann Drive, Blair, NE 68008 2007-10-01
1497956478 Charles Leroy Gleeson Pharmacist 9889 Cr 29, Blair, NE 68008 2007-05-29
1144322082 Richard K Ward Emergency Medicine 810 N. 22nd Street, Mch & Health System, Blair, NE 68008 2006-09-01
1942319116 Lisa A. Babcock Audiologist 11223 N. Lakeshore Dr., Blair, NE 68008 2006-08-30
1841637139 Paula J. Thielen-kocharov Family Medicine 812 N 22nd St, Blair, NE 68008 2013-05-28
1588849848 Vision Care Clinic PC Optometrist 1526 Washington St, Blair, NE 68008 2008-01-07
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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Competitor

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City BLAIR
Zip Code 68008

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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