Provider Demographics
NPI:1063584159
Name:KOHLES, ROBERT D (MA LMHP LIMHP CPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:D
Last Name:KOHLES
Suffix:
Gender:M
Credentials:MA LMHP LIMHP CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 NORTH 12TH RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NE
Mailing Address - Zip Code:68418
Mailing Address - Country:US
Mailing Address - Phone:402-780-5558
Mailing Address - Fax:
Practice Address - Street 1:1903 4TH CORSO
Practice Address - Street 2:BLUE VALLEY MENTAL HEALTH CENTER
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410
Practice Address - Country:US
Practice Address - Phone:402-873-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE657101YP2500X
NE537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE84334OtherBCBS
NE8353OtherMIDLANDS CHOICE
NE91015OtherBCBS AUX NUMBER