Active NPI
Jason Boglio
- Mental Health Counselor
- Orlando, FL
National Provider Identifier
1114652088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 17211
- Practice address
- 3222 Corrine Dr
Orlando, FL 32803-2217 - Phone
- (407) 694-9128
- NPI assigned
- Jul 23, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 17211 | FL | Primary |
Addresses
Primary practice location
3222 Corrine Dr
Orlando, FL 32803-2217
Mailing address
1775 Wentwood Ave
Orlando, FL 32804-1154
Phone (407) 694-9128
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17211 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658534400000",
"number": "1114652088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1775 WENTWOOD AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328041154",
"telephone_number": "407-694-9128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3222 CORRINE DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328032217",
"telephone_number": "407-694-9128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGLIO",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-23",
"last_updated": "2022-07-23",
"certification_date": "2022-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "17211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.