Provider Demographics
NPI:1124084157
Name:KAYNE, JON B (MSW, PHD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:B
Last Name:KAYNE
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 MCCARTY DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1185
Mailing Address - Country:US
Mailing Address - Phone:402-216-3917
Mailing Address - Fax:402-291-8018
Practice Address - Street 1:4212 MCCARTY DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-1185
Practice Address - Country:US
Practice Address - Phone:402-216-3917
Practice Address - Fax:402-291-8018
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10101Y00000X
NE1451041C0700X
NE359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE82452OtherBCBS PROVIDER #
NE089775Medicare PIN