Kevin Lee Boblitt, MA, LMHC
Individual provider Active NPI Mental Health Counselor · Valparaiso, IN
NPI 1528055514 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1528055514
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 39001569A (IN)
- Practice address
- 601 Wall St
Valparaiso, IN 46383-2512 - Phone
- (219) 531-3500
- NPI assigned
- Oct 4, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20231229002703 | OH | Practitioner - Mental Health Counselor | 1456701630 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39001569A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Behavioral Health, Inc. | Current |
Accepting new patients | |
| Samaritan Behavioral Health, Inc. | Current | Accepting new patients | |
| Samaritan Behavioral Health, Inc. | Current |
Accepting new patients |
Locations
601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333
601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/sbhihelp/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001569A | IN | Yes |
Addresses
Primary practice location
601 Wall St
Valparaiso, IN 46383-2512
Mailing address
1209 W 21St St
Laporte, IN 46350-6471
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000316976 | Other | IN | ANTHEM |
Other providers in Valparaiso, IN
- Maximo V. Bleza
- Block & Stevenson Oms PC
- Bloom Counseling LLC
- Kenneth Wayne Blumenthal
- Courtney Bobier
- Allison Grace Bodine
- Tessa Bodish
- Samantha Nicole Bogacz
- Sara Bokodi
- Dean Boldin
All providers in Valparaiso, IN · Mental Health Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.