Active NPI
Kathleen Blake
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1407401185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3113
- Practice address
- 13322 I St
Omaha, NE 68137-1111 - Phone
- (402) 230-5861
- Fax
- (531) 200-5808
- NPI assigned
- Aug 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Counselor | 101YM0800X | 3113 | NE | Primary |
Addresses
Primary practice location
13322 I St
Omaha, NE 68137-1111
Mailing address
13322 I St
Omaha, NE 68137-1111
Phone (402) 230-5861
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 |
|---|---|---|---|
| 3113 | NE | MD | School Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cohrs Behavioral Consulting, LLC | Mental Health | Past | Accepting new patients |
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": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1407401185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13322 I ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681371111",
"telephone_number": "402-230-5861",
"fax_number": "531-200-5808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13322 I ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681371111",
"telephone_number": "402-230-5861",
"fax_number": "531-200-5808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "KATHLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-08",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "3113",
"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 Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.