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NPI Code Detail

MEDICARE: MR. KEVIN LEE BOBLITT MA, LMHC

MEDICARE: MR. KEVIN LEE BOBLITT MA, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor39001569AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000316976OTHERINANTHEM

General Provider Information

NPI Number : 1528055514
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN LEE BOBLITT MA, LMHC
Provider Business Mailing Address
First Line : 1209 W 21ST ST
Second Line :
City : LAPORTE
State : IN
Zip : 46350-6471
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 601 WALL ST
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-2512
Country : US
Telephone Number : 219-531-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 07/08/2007

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