Kenneth Clark Komyathy, LCSW

Individual provider Active NPI Clinical Social Worker · Offutt a F B, NE

NPI 1114911591 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1114911591
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1084 (NE)
Practice address
55 Mdos Sgo
2501 Capehart Road
Offutt a F B, NE 68113-1712
Phone
(402) 294-7886
Fax
(402) 232-7291
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
55 Mdos Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1084 NE Yes

Addresses

Primary practice location

55 Mdos Sgo
2501 Capehart Road
Offutt a F B, NE 68113-1712

Mailing address

55 Mdos Sgo
2501 Capehart Road
Offutt a F B, NE 68113-1712
Phone (402) 294-7886

Other providers in Offutt a F B, NE

All providers in Offutt a F B, NE · Clinical Social Worker in Nebraska

Sources for this page

Verify at the official NPI Registry.