Individual provider Active NPI

Kendall Holland

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1750125167
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8601 W Dodge Rd Ste 106
Omaha, NE 68114-3430
Phone
(402) 575-5577
Fax
(531) 213-4131
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 Primary

Addresses

Primary practice location

8601 W Dodge Rd Ste 106
Omaha, NE 68114-3430

Mailing address

8601 W Dodge Rd Ste 106
Omaha, NE 68114-3430
Phone (402) 575-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20260512001361 SD Practitioner - Mental Health Counselor 5597234294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5000 S Broadband LN
Suite 119
Sioux Falls, SD 57108-2261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Counseling Omaha, LLC CurrentSince Jun 23, 2024 Accepting new patients

Locations

8601 W Dodge Rd
Ste 106
Omaha, NE 68114
Phone (402) 205-8603

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1750125167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 W DODGE RD STE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143430",
            "telephone_number": "402-575-5577",
            "fax_number": "531-213-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 W DODGE RD STE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143430",
            "telephone_number": "402-575-5577",
            "fax_number": "531-213-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "KENDALL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.