NPIMap

Individual provider Active NPI

Kimberly S. Havens, BA, ACADC; LADC

  • Addiction (Substance Use Disorder) Counselor
  • Omaha, NE
National Provider Identifier
1194881912
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
896 Issued in NE
Practice address
2808 N 75TH St
Suite H
Omaha, NE 68134-6861
Phone
(402) 932-9412
Fax
(402) 932-3557
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 09132 IA
Addiction (Substance Use Disorder) Counselor 101YA0400X 896 NE Primary

Addresses

Primary practice location

2808 N 75TH St
Suite H
Omaha, NE 68134-6861

Mailing address

2808 N 75TH St
Suite H
Omaha, NE 68134-6861
Phone (402) 932-9412

Other identifiers 1

IdentifierTypeStateIssuer
01015OtherIACADC

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
09132IAMDAddiction (Substance Use Disorder) Counselor
896NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inroads to Recovery, Inc Addiction (Substance Use Disorder) Past Accepting new patients
Inroads Counseling Services PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1194881912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 N 75TH ST",
            "address_2": "SUITE H",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346861",
            "telephone_number": "402-932-9412",
            "fax_number": "402-932-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 N 75TH ST",
            "address_2": "SUITE H",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346861",
            "telephone_number": "402-932-9412",
            "fax_number": "402-932-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "KIMBERLY",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "BA, ACADC;  LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "09132",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "01015",
            "state": "IA"
        }
    ],
    "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 Jun 22, 2011; 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.