Healthcare Provider Details

I. General information

NPI: 1649104878
Provider Name (Legal Business Name): MS. RONDA LEE BOKELMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 COUNTY ROAD 57
ALLIANCE NE
69301-6051
US

IV. Provider business mailing address

442 HENKENS DR
CHADRON NE
69337-2448
US

V. Phone/Fax

Practice location:
  • Phone: 308-430-0675
  • Fax:
Mailing address:
  • Phone: 308-430-0675
  • Fax: 308-430-0675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14945
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: