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Kevin Lee Boblitt

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as KEVIN BOBLITT.

Based on the most recent information from CMS, provider Kevin Lee Boblitt is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:05 AM.

Profile Details

Provider ID
1528055514
Provider Type
Individual
Full Name
Boblitt, Kevin Lee
Title
Mr.
Credential
MA, LMHC

Gender
Male
Sole Proprietor
No
Enumeration Date
10/4/2005
Last Updated
7/8/2007

Contact Information

Practice Location

601 Wall St, Valparaiso, IN 46383-2512

(219) 531-3500

Unlisted Fax

Mailing Location

1209 W 21st St, Laporte, IN 46350-6471

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 39001569A Indiana

Provider Identifiers

ID	Description	Issuer
ID 000000316976	Description Other	Issuer ANTHEM Indiana

Kevin Lee Boblitt

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Zaremba, Samantha

Young, Teresa L

Williams, Vera

Niewenhuis, Linden

Wardell, Nicholas

Valtierra, Melissa E

Faithful Counseling And Therapy Services, Llc

Eberstein, Debra Lynn

Hickman, Dawn

Matheus, Elizabeth S