Healthcare Provider Details

I. General information

NPI: 1508721697
Provider Name (Legal Business Name): REACHING IVY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 FORT CROOK RD S
BELLEVUE NE
68005-3061
US

IV. Provider business mailing address

15340 DAVIDSON ST
BENNINGTON NE
68007-5460
US

V. Phone/Fax

Practice location:
  • Phone: 402-242-3745
  • Fax:
Mailing address:
  • Phone: 402-242-3745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROSE KERN
Title or Position: OWNER/LICENSED MENTAL HEALTH
Credential: LMHP, MAMT, MT-BC
Phone: 402-242-3745