Kelly, Mike B

Kelly, Mike B is an sole proprietor health care provider with primary practice located at 3810 Central Ave , Kearney NE 68847-8134. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Kelly, Mike B can be contacted via phone (308) 237-5951.

Contact Information

Primary practice address
3810 Central Ave Kearney NE 68847-8134
Phone: (308) 237-5951
Fax: (308) 234-4018
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X P-939 Nebraska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2718 Nebraska
Behavioral Health & Social Service Providers / Professional 101YP2500X 1446 Nebraska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 928 Nebraska

Profile Details

NPI number 1902967227
LBN Legal business name Kelly, Mike B
Credentials M.A., LIMHP, PLADC,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Dec 4th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902967227 NPPES
Nebraska MEDICAID 10025451701

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