Provider Demographics
NPI:1699938035
Name:ROD W. KOHL, P.C.
Entity type:Organization
Organization Name:ROD W. KOHL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:W
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-423-3359
Mailing Address - Street 1:1617 NORMANDY CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-1474
Mailing Address - Country:US
Mailing Address - Phone:402-420-1617
Mailing Address - Fax:402-420-1619
Practice Address - Street 1:1617 NORMANDY CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1474
Practice Address - Country:US
Practice Address - Phone:402-420-1617
Practice Address - Fax:402-420-1619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty