Constance W Boehner, HSPP
Individual provider Active NPI Clinical Psychologist · Lawrenceburg, IN
NPI 1053462010 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1053462010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 20041884A (IN)
- Practice address
- 427 W Eads Pkwy
Lawrenceburg, IN 47025-1139 - Phone
- (812) 537-7375
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041884A | IN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NPI 1407175557 | Past | Accepting new patients | |
| Community Mental Health Center Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20041884A | IN | Yes |
Addresses
Primary practice location
427 W Eads Pkwy
Lawrenceburg, IN 47025-1139
Mailing address
285 Bielby Rd
Lawrenceburg, IN 47025-1055
Phone (812) 537-1302
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000283805 | Other | IN | BLUE SHIELD |
Other providers in Lawrenceburg, IN
- Melissa Bischoff
- Diane Marie Bishop
- Patricia C Blank
- Keith William Blankman
- Joicelyn Akua Boahemaa-Yeboah
- Ashley M. F. Boles
- Holly Louise Bonomini
- Joseph Bonomini
- John A Botsford
- Bashar Bouso
All providers in Lawrenceburg, IN · Clinical Psychologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.