Provider Demographics
NPI:1023274206
Name:RECH, KIM KENYON (PLMHP)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:KENYON
Last Name:RECH
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 MAGNET ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3607
Mailing Address - Country:US
Mailing Address - Phone:402-640-5595
Mailing Address - Fax:
Practice Address - Street 1:4432 SUNRISE PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3958
Practice Address - Country:US
Practice Address - Phone:402-564-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8393101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)