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KENNEDY SHORES
NPI 1891500526
Peer Specialist in Norfolk, NE

Active since February 10, 2025
333 W NORFOLK AVE STE 201, NORFOLK, NE 68701(402) 379-2030 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 11, 2025, Feb 10, 2025 (2 updates tracked since 2025).

About Kennedy Shores NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDY SHORES (NPI 1891500526) is an individual peer specialist in Norfolk, Nebraska, licensed in Nebraska (399) and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1891500526
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKENNEDY SHORES
Location Address333 W NORFOLK AVE STE 201Norfolk, NE 68701-5221
Mailing Address333 W Norfolk Ave Ste 201Norfolk, NE 68701-5221 · (402) 379-2030
Phone(402) 379-2030
Sole ProprietorNo
Enumeration DateFebruary 10, 2025
Last NPPES UpdateApril 11, 20252 updates tracked since enumeration
NPPES CertifiedApril 11, 2025
✔ NPI 1891500526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in NE · 399
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License P-2247 (NE)
333 W NORFOLK AVE STE 201, Norfolk, NE 68701
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENT JAMES SELL PLADC
Counselor (Addiction (Substance Use Disorder))
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
SCOTT N BRUENING
Case Manager/Care Coordinator
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
MRS. RACHEL MARIE MANN APRN
Nurse Practitioner (Psychiatric/Mental Health)
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
MR. DOMINIC THOMAS WOLFF PLMHP
Counselor (Mental Health)
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
JESSICA J CLYDE
Case Manager/Care Coordinator
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
DON R BROADUS
Case Manager/Care Coordinator
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
AUTUMN ROSE PATRICK
Counselor (Addiction (Substance Use Disorder))
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030
MARIA GROTHE
Case Manager/Care Coordinator
333 W NORFOLK AVE STE 201
NORFOLK, NE 68701
Madison County (402) 379-2030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedy Shores's NPI number?

The NPI number for Kennedy Shores is 1891500526. It was assigned to this individual provider in the NPPES registry on February 10, 2025.

Where is Kennedy Shores located?

Kennedy Shores practices at 333 W Norfolk Ave Ste 201, Norfolk, NE 68701. The listed phone number is (402) 379-2030.

What is Kennedy Shores's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kennedy Shores was last updated on April 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.