Michele Janine Boberg, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041822A Issued in IN

Practice address

4607 N Wheeling Ave
Muncie, IN 47304-1220

Phone

(765) 288-1110

Fax

(765) 288-4044

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associates in Behavioral Counseling PCGroup PAC ID 2062466063, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associates in Behavioral Counseling PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muncie, IN
  • NPI 1982631164
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053499749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N BITTERSWEET LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043754",
            "telephone_number": "765-286-8788",
            "fax_number": "765-288-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041220",
            "telephone_number": "765-288-1110",
            "fax_number": "765-288-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBERG",
        "first_name": "MICHELE",
        "middle_name": "JANINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041822A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "708119000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000316087",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "500867",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200451310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubree Block
• Bloom & Be Therapy and Educational Services
• Bloom Dental - Muncie LLC
• Chase Edward Bly, PA
• Meredith Boatwright, LMHC
• Praveen Kumar Boddu, MD
• Ashley Lynn Boester-Dean, PH.D., HSPP
• Julie Renee Bogue, NP
• Megan Michelle Bohm, LCSW
• Joshua Bokelman, RPH.

• Clinical Psychologist in Muncie, IN
• Providers in Muncie, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.