Alicia Boreman-Menke, LPC/CR

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C.1400233-CR Issued in OH

Practice address

5647 Mayberry Square
Sylvania, OH 43560-9456

Phone

(419) 819-8428

NPI assigned

May 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Unity Behavioral Health

  • Mental Health Counselor
  • Port Clinton, OH
  • NPI 1811736804
  NPD
• Unity Counseling Services LLC

  • Mental Health Counselor
  • Woodville, OH
  • NPI 1407537608
  NPD
• United Labor Agency

  • Mental Health Counselor
  • Cleveland, OH
  • NPI 1265204051
  NPD (past)

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1104205194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 BERDAN AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134805",
            "telephone_number": "419-819-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 MAYBERRY SQUARE",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435609456",
            "telephone_number": "419-819-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREMAN-MENKE",
        "first_name": "ALICIA",
        "name_prefix": "Mrs.",
        "credential": "LPC/CR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1400233-CR",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1400233-CR",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van B Boggus, M.D.
• Bold Beginnings Center LLC
• Gina Renee Bollman, PTA
• James J Bomer, MD
• Meghan Booth
• Kelly Potter Borgman, PT
• Tabitha Bosinger, PA
• Raul Martin Bosio, M.D., M.S.B.S.
• Emily M Boston, LISW-S LICDC-CS
• Laurie A Boudreaux, PA-C

• Counselor in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.