Individual provider Active NPI

Kyle Wockenfuss, LMHP, CPC, NCC

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1164860102
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5154 Issued in NE
Practice address
5930 S 58TH St Ste J
Lincoln, NE 68516-3653
Phone
(402) 623-0050
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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 9988 NE
Mental Health Counselor 101YM0800X 5154 NE Primary

Addresses

Primary practice location

5930 S 58TH St Ste J
Lincoln, NE 68516-3653

Mailing address

19839 SW 100TH St
Crete, NE 68333-2593
Phone (402) 418-1540

Other practice location 1

3900 Dakota Ave
Suite 9
South Sioux City, NE 68776-3696
Phone (402) 418-1540

Other practice location 2

4747 Pioneers Blvd Ste 10B
Lincoln, NE 68506-5313
Phone (402) 413-7173

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

LicenseStateTypeSpecialty
9988NEMDMental Health Counselor
5154NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Counseling & Consultation LLC Mental Health CurrentSince Apr 17, 2022 Accepting new patients

Locations

5930 S 58th St
Ste J
Lincoln, NE 68516
Phone (402) 473-1911

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.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1164860102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19839 SW 100TH ST",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683332593",
            "telephone_number": "402-418-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 S 58TH ST STE J",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163653",
            "telephone_number": "402-623-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Dakota Ave",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "South Sioux City",
            "state": "NE",
            "postal_code": "687763696",
            "country_code": "US",
            "telephone_number": "402-418-1540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4747 Pioneers Blvd Ste 10B",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685065313",
            "country_code": "US",
            "telephone_number": "402-413-7173",
            "fax_number": "402-625-0754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOCKENFUSS",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "LMHP, CPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9988",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "5154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.

Verify at the official NPI Registry.