Individual provider Active NPI

Craig Wheeler Boas, LCSW-C

  • Clinical Social Worker
  • Lutherville Timonium, MD
National Provider Identifier
1093956336
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09779 Issued in MD
Practice address
1400 Front Ave Ste 305
Lutherville Timonium, MD 21093-5364
Phone
(443) 823-9122
Fax
(410) 560-0031
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 09779 MD Primary

Addresses

Primary practice location

1400 Front Ave Ste 305
Lutherville Timonium, MD 21093-5364

Mailing address

1400 Front Ave Ste 305
Lutherville Timonium, MD 21093-5364
Phone (443) 823-9122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20090420000078 MD Practitioner - Clinical Social Worker 1355498940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

605 Goucher Ave
Lutherville, MD 21093-5008
Phone (443) 823-9122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09779MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boas Psychotherapy, LLC Clinical CurrentSince Aug 23, 2021 Accepting new patients

Locations

1400 Front Ave
Ste 305
Timonium, MD 21093
Phone (410) 696-5013

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1093956336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE STE 305",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210935364",
            "telephone_number": "443-823-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE STE 305",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210935364",
            "telephone_number": "443-823-9122",
            "fax_number": "410-560-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAS",
        "first_name": "CRAIG",
        "middle_name": "WHEELER",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2022-03-08",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville Timonium, MD

Sources for this page

Verify at the official NPI Registry.