Individual provider Active NPI

Rick D Boehm, LMHC, MAC, MS

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1104007269
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00005696 Issued in WA
Practice address
400 E Evergreen Blvd
Suite 108
Vancouver, WA 98660-3331
Phone
(360) 906-8160
Fax
(360) 906-8194
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MAC501835 WA
Mental Health Counselor 101YM0800X LH00005696 WA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00002340 WA

Addresses

Primary practice location

400 E Evergreen Blvd
Suite 108
Vancouver, WA 98660-3331

Mailing address

400 E Evergreen Blvd
Suite 108
Vancouver, WA 98660-3331
Phone (360) 906-8160

Other names 1

  • Ricky D Boehm Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CP00002340WAMDAddiction (Substance Use Disorder) Counselor
MAC501835WAMDAddiction (Substance Use Disorder) Counselor
LH00005696WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1104007269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E EVERGREEN BLVD",
            "address_2": "SUITE 108",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603331",
            "telephone_number": "360-906-8160",
            "fax_number": "360-906-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EVERGREEN BLVD",
            "address_2": "SUITE 108",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603331",
            "telephone_number": "360-906-8160",
            "fax_number": "360-906-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "RICK",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LMHC, MAC, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "MAC501835",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00005696",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00002340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICKY",
            "last_name": "BOEHM",
            "middle_name": "D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.