Healthcare Provider Details

I. General information

NPI: 1134083132
Provider Name (Legal Business Name): KOCOL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11707 M CIR
OMAHA NE
68137-2218
US

IV. Provider business mailing address

11512 S 115TH ST
PAPILLION NE
68046-4520
US

V. Phone/Fax

Practice location:
  • Phone: 402-536-9280
  • Fax:
Mailing address:
  • Phone: 402-536-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: RACHEL KOCOL
Title or Position: MENTAL HEALTH THERAPIST
Credential: LMHP
Phone: 402-536-9280