Provider Demographics
NPI:1669265682
Name:WOODRASKA, MICHAEL A (PLMHP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:WOODRASKA
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:VALENTINE
Mailing Address - State:NE
Mailing Address - Zip Code:69201-1714
Mailing Address - Country:US
Mailing Address - Phone:402-376-6736
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 26
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-0026
Practice Address - Country:US
Practice Address - Phone:402-684-2908
Practice Address - Fax:402-913-3454
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health