Randell Allen Kohberger | Las Vegas, NV • PECOS Search

Randell Allen Kohberger

Counselor

Behavioral Health & Social Service Providers

7465 W Lake Mead Blvd Ste 103, Las Vegas, NV 89128-1032

(702) 562-1293 (702) 798-3356

PECOS Enrollment

Based on the most recent information from CMS, provider Randell Allen Kohberger does not have current enrollment records in PECOS.

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

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1619626587
Provider Type
Individual
Full Name
Kohberger, Randell Allen
Gender
Male

Sole Proprietor
No
Enumeration Date
3/19/2022
Last Updated
3/19/2022

Contact Information

Practice Location

7465 W Lake Mead Blvd Ste 103, Las Vegas, NV 89128-1032

Unlisted Fax

Mailing Location

505 E Windmill Ln Ste 1c, Las Vegas, NV 89123-1870

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer