NPIMap

Organization Active NPI

Supertherapy

  • Mental Health Counselor
  • Madison, OH
National Provider Identifier
1104664341
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SUPERTHERAPY
Practice address
59 S Lake St
Madison, OH 44057-3245
Phone
(234) 212-8254
NPI assigned
Jul 19, 2024
Organization subpart
No

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Michael BoyceNPI 1992331722
Title
Clinical Counselor
Phone
(234) 212-8254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

59 S Lake St
Madison, OH 44057-3245

Mailing address

59 S Lake St
Madison, OH 44057-3245
Phone (234) 212-8254

Other names 2

  • Supertherapy Doing business as
  • Michael Boyce Other name

NPI Registry JSON

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1104664341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 S LAKE ST",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573245",
            "telephone_number": "234-212-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 S LAKE ST",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573245",
            "telephone_number": "234-212-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "BOYCE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL COUNSELOR",
        "authorized_official_telephone_number": "234-212-8254"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supertherapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michael Boyce",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madison, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.