Active NPI
Kenneth Beau Boryca, M.S.E, LMHP, LADC
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1154796084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4898
- Practice address
- 2240 Landon CT
Omaha, NE 68102-2414 - Phone
- (402) 346-0902
- Fax
- (402) 342-5290
- NPI assigned
- Dec 3, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1111 | NE | |
| Mental Health Counselor | 101YM0800X | 4898 | NE | Primary |
Addresses
Primary practice location
2240 Landon CT
Omaha, NE 68102-2414
Mailing address
2240 Landon CT
Omaha, NE 68102-2414
Phone (402) 346-0902
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 |
|---|---|---|---|
| 4898 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1154796084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2240 LANDON CT",
"city": "OMAHA",
"state": "NE",
"postal_code": "681022414",
"telephone_number": "402-346-0902",
"fax_number": "402-342-5290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 LANDON CT",
"city": "OMAHA",
"state": "NE",
"postal_code": "681022414",
"telephone_number": "402-346-0902",
"fax_number": "402-342-5290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORYCA",
"first_name": "KENNETH",
"middle_name": "BEAU",
"credential": "M.S.E, LMHP, LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-03",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "1111",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "4898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.