Individual provider Active NPI

Kevin Lee Boblitt, MA, LMHC

  • Mental Health Counselor
  • Valparaiso, IN
National Provider Identifier
1528055514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001569A Issued in IN
Practice address
601 Wall St
Valparaiso, IN 46383-2512
Phone
(219) 531-3500
NPI assigned
Oct 4, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001569A IN Primary

Addresses

Primary practice location

601 Wall St
Valparaiso, IN 46383-2512

Mailing address

1209 W 21St St
Laporte, IN 46350-6471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229002703 OH Practitioner - Mental Health Counselor 1456701630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
39001569AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Behavioral Health, Inc. Current Accepting new patients
Samaritan Behavioral Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Samaritan Behavioral Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310

601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sbhihelp/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528055514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W 21ST ST",
            "city": "LAPORTE",
            "state": "IN",
            "postal_code": "463506471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBLITT",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001569A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.