Provider Demographics
NPI:1689174898
Name:VANKAT, JOHN J
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:VANKAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 GALVIN RD S
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-3064
Mailing Address - Country:US
Mailing Address - Phone:402-292-6006
Mailing Address - Fax:402-292-7465
Practice Address - Street 1:10685 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3684
Practice Address - Country:US
Practice Address - Phone:402-292-6006
Practice Address - Fax:402-292-7465
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000OtherLICENSURE BOARD