Active NPI
Willow Kovanda
- Counselor
- Papillion, NE
National Provider Identifier
1053851691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 11127
- Practice address
- 302 American Pkwy
Papillion, NE 68046-6270 - Phone
- (402) 339-2544
- NPI assigned
- Mar 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 11127 | NE | Primary |
Addresses
Primary practice location
302 American Pkwy
Papillion, NE 68046-6270
Mailing address
7480 Dodson PLZ Apt 204
Ralston, NE 68127-4291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11127 | NE | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mind Over Matter Counseling Services LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Papillion, NE
- NPI 1750872149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488326400000",
"number": "1053851691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7480 DODSON PLZ APT 204",
"city": "RALSTON",
"state": "NE",
"postal_code": "681274291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 AMERICAN PKWY",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680466270",
"telephone_number": "402-339-2544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOVANDA",
"first_name": "WILLOW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-01",
"last_updated": "2017-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NE",
"license": "11127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Papillion, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.