Jack, Michelle D

Jack, Michelle D is an individual health care provider with primary practice located at 914 Baumann Dr , Grand Island NE 68803-4401. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jack, Michelle D can be contacted via phone (308) 385-5250.

Contact Information

Primary practice address
914 Baumann Dr Grand Island NE 68803-4401
Phone: (308) 385-5250
Fax: (308) 385-5271
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1164 Nebraska
Behavioral Health & Social Service Providers / Clinical 1041C0700X 657 Nebraska

Profile Details

NPI number 1558754945
LBN Legal business name Jack, Michelle D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2015
Last updated Mar 10th, 2015 - about 11 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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