Individual provider Active NPI

Robert D Kohles, MA LMHP LIMHP CPC

  • Mental Health Counselor
  • Nebraska City, NE
National Provider Identifier
1063584159
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
537 Issued in NE
Practice address
1903 4TH Corso
Blue Valley Mental Health Center
Nebraska City, NE 68410
Phone
(402) 873-5505
NPI assigned
Nov 14, 2006
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 537 NE Primary
Professional Counselor 101YP2500X 657 NE

Addresses

Primary practice location

1903 4TH Corso
Blue Valley Mental Health Center
Nebraska City, NE 68410

Mailing address

437 North 12TH Rd
Palmyra, NE 68418
Phone (402) 780-5558

Other identifiers 3

IdentifierTypeStateIssuer
8353OtherNEMIDLANDS CHOICE
91015OtherNEBCBS AUX NUMBER
84334OtherNEBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240603000548 NE Practitioner - Mental Health Counselor 9739621061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

302 S 16TH St
Suite B
Aurora, NE 68818-3000

437 N 12TH Rd
Palmyra, NE 68418-4002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
657NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Health Centers LLC Mental Health CurrentSince May 1, 2024 Accepting new patients
Blue Valley Behavioral Health Inc Past Accepting new patients

Locations

4719 Prescott Ave
Lincoln, NE 68506
Phone (402) 235-8184

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1063584159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 NORTH 12TH RD",
            "city": "PALMYRA",
            "state": "NE",
            "postal_code": "68418",
            "telephone_number": "402-780-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 4TH CORSO",
            "address_2": "BLUE VALLEY MENTAL HEALTH CENTER",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "68410",
            "telephone_number": "402-873-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLES",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MA LMHP LIMHP CPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "537",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "8353",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AUX NUMBER",
            "identifier": "91015",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84334",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nebraska City, NE

Sources for this page

Verify at the official NPI Registry.