Healthcare Provider Details

I. General information

NPI: 1740344738
Provider Name (Legal Business Name): KAIROS PSYCHOLOGICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11905 ARBOR ST
OMAHA NE
68144-2970
US

IV. Provider business mailing address

11905 ARBOR ST
OMAHA NE
68144-2970
US

V. Phone/Fax

Practice location:
  • Phone: 402-330-0800
  • Fax: 402-330-8873
Mailing address:
  • Phone: 402-330-0800
  • Fax: 402-330-8873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNE

VIII. Authorized Official

Name: DR. ROBERT G. KRAFT
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 402-330-0800