Marvin Ora Crouch, L.I.M.H.P., L.A.D.C.
Individual provider Active NPI Mental Health Counselor · Kearney, NE
NPI 1407930944 · NPPES record last updated Feb 18, 2014
Key facts
- NPI
- 1407930944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 35 (NE)
- Practice address
- 2811 30TH Ave
Kearney, NE 68845-4036 - Phone
- (308) 237-6865
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Kearney Counseling Associates LLC
Practice addresses (Care Compare)
2811 30TH Ave
Kearney, NE 68845-4036
Phone (308) 237-6865
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240119000150 | NE | Practitioner - Mental Health Counselor | 6103101142 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 621 | NE | MD | Mental Health Counselor |
| 296 | NE | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kearney Counseling Associates LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
2811 30th Ave
Kearney, NE 68845
Phone (308) 237-6865
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 296 | NE | |
| Mental Health Counselor | 101YM0800X | 35 | NE | Yes |
| Professional Counselor | 101YP2500X | 621 | NE |
Addresses
Primary practice location
2811 30TH Ave
Kearney, NE 68845-4036
Mailing address
7450 W 29TH St
Kearney, NE 68845-8808
Phone (308) 234-1148
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100025152000 | Medicaid | NE | |
| 100025152100 | Medicaid | NE |
Other providers in Kearney, NE
- Lydia Crocker
- Heber Cless Crockett
- William Curtis Crockett
- Madaline Patrice Crome
- William Crosier
- Lindsay Crowell
- McKenzie Jenae Cuba
- Karri Cumming
- Claire A Cunningham
- Stephanie S Cunningham
All providers in Kearney, NE · Mental Health Counselor in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.