Connor Edwin Kendzora

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13896 Issued in NE

Practice address

6902 Pine St
Omaha, NE 68106-2855

Phone

(402) 559-6418

Fax

(402) 559-5737

NPI assigned

Jan 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1821628496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-8943",
            "fax_number": "402-559-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6902 PINE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062855",
            "telephone_number": "402-559-6418",
            "fax_number": "402-559-5737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16782 Von Karman Ave Ste 11",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926062417",
            "country_code": "US",
            "telephone_number": "949-833-2237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDZORA",
        "first_name": "CONNOR",
        "middle_name": "EDWIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "13896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin K Kendall
• Ganeva Kendall, MD
• Lauren Elizabeth Kendall, MOT, OTR/L
• Weston Kendall
• Stacy Kendrick
• Angela A Kenedy, LIMHP, LCSW, LADC
• Jay G Kenik, M.D.
• Amy J Kenkel, APRN
• Ashley Mary Kenkel
• Jean C Kenkel, APRN

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.