MIKE B KELLY (NPI# 1902967227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902967227 |
| Entity Type | Individual |
| Full Name | MIKE B KELLY |
| Other Name | MICHAEL B. KELLY-DEFREECE |
| Credential | M.A., LIMHP, PLADC, |
| Practice Address |
3810 Central Ave Kearney NE 68847-8134 |
| Practice Telephone | 3082375951 |
| Practice Fax Number | 3082344018 |
| Mailing Telephone | 0832375951 |
| Mailing Fax Number | 3082344018 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
P-939 | NE | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
928 | NE | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
2718 | NE | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
1446 | NE | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025451701 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 616 W 5th St, Hastings, NE 689015104 | 4024635684 | 4024635686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521756 | Mike Kelly | Behavior Technician | 1081 3rd Ave Sw Ste 7, Carmel, IN 46032-7500 | 2020-09-01 |
| Street Address |
3810 CENTRAL AVE |
| City | KEARNEY |
| State | NE |
| Zip Code | 68847-8134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043758279 | Kelli Brueggemann | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2017-02-08 |
| 1164891628 | Sara Ramsay | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2015-09-15 |
| 1679996342 | Brett Lee Fries | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2014-01-30 |
| 1417391640 | Sondra Mckinney | Social Worker | 3810 Central Ave, Kearney, NE 68847-8134 | 2013-04-18 |
| 1124462361 | Hannah Troyer | Psychologist | 3810 Central Ave, Kearney, NE 68847-8134 | 2013-04-18 |
| 1104160266 | Abbie Olson | Social Worker | 3810 Central Ave, Kearney, NE 68847-8134 | 2012-11-15 |
| 1356614747 | Karrie A Schoenefeld | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2012-02-15 |
| 1972874493 | Kara Kliewer | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2012-01-13 |
| 1245515246 | Teresa Machnicki | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2011-10-21 |
| 1891075800 | Kim Anderson | Counselor | 3810 Central Ave, Kearney, NE 68847-8134 | 2011-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427506419 | Mckenzie Rae Behrendt | Occupational Therapist | 3219 Central Ave Ste 105, Kearney, NE 68847 | 2016-09-19 |
| 1912366816 | Rylee Anne Horsley | Nurse Practitioner | 5609 1st Avenue Suite B, Kearney, NE 68847 | 2016-02-19 |
| 1255626321 | Jody Lynn Angel-trejo | Counselor | 15 W 22nd St, Kearney, NE 68847 | 2011-06-16 |
| 1881985646 | Med-care, Inc | Specialist | 920 E 56th, Kearney, NE 68847 | 2011-04-28 |
| 1396979985 | Brad Henry Greisen | Registered Nurse | 115 East 52nd St, Kearney, NE 68847 | 2009-05-11 |
| 1528221520 | Andrea Christine Johnson | Physician Assistant | 10 East 31st Street, Kearney, NE 68847 | 2008-07-09 |
| 1528236189 | Morgan Medical LLC | Durable Medical Equipment & Medical Supplies | 3819 2nd Avenue, Kearney, NE 68847 | 2008-02-18 |
| 1134307358 | Linda Kay Shaw | Counselor | 904 E. 25th, Kearney, NE 68847 | 2008-02-11 |
| 1528245669 | David Emst Jenny | General Practice | 819 East 48th St, Kearney, NE 68847 | 2008-01-30 |
| 1386827855 | Nathaniel Alan Gaunt | Chiropractor | 218 W 42nd St, Kearney, NE 68847 | 2007-12-07 |
| Find all providers in zip 68847 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972136166 | Jen Myers Counseling Inc | Counselor | 124 W 46th St Ste 106, Kearney, NE 68847-8348 | 2020-02-17 |
| 1861036923 | E5counseling, LLC | Counselor | 2315 W 39th St Ste 113, Kearney, NE 68845-8327 | 2019-11-01 |
| 1477049351 | Margaret H Snyder | Counselor | 2303 13th Ave, Kearney, NE 68845-5032 | 2018-07-03 |
| 1891287959 | Olivia Frerichs | Counselor | 2315 W 39th St Unit 2, Kearney, NE 68845-8327 | 2018-06-05 |
| 1659892909 | Kayla Marie Schachta | Counselor | 4010 R Ave Apt E8, Kearney, NE 68847-2315 | 2017-06-27 |
| 1558800342 | Brandon Frerichs | Counselor | 2202 Central Ave Ste 12, Kearney, NE 68847-5359 | 2017-02-14 |
| 1447794219 | Family Network PC | Counselor | 415 W 33rd St, Kearney, NE 68845-3460 | 2016-12-13 |
| 1760818389 | Kiffany Ann Conner | Counselor | 1325 W 112th St, Kearney, NE 68845-1436 | 2013-09-16 |
| 1851640627 | Jeremy J Starzec | Counselor | 3709 Central Ave, Kearney, NE 68847-8131 | 2012-09-07 |
| 1386906972 | Terry L. Dunlop | Counselor | 2315 W. 39th St., Suite 109, Kearney, NE 68845 | 2012-06-11 |
| Find all providers in KEARNEY | ||||
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| 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.