Individual provider Active NPI

Anthony Durkin

  • Mental Health Counselor
  • Boardman, OH
National Provider Identifier
1184261968
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2505493 Issued in OH
Practice address
725 Boardman Canfield Rd Ste L1
Boardman, OH 44512-4370
Phone
(330) 330-8655
Fax
(330) 330-8657
NPI assigned
Nov 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OH
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X E.2505493 OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd Ste L1
Boardman, OH 44512-4370

Mailing address

725 Boardman Canfield Rd Ste L1
Boardman, OH 44512-4370
Phone (330) 330-8655

Other practice location 1

16 Evans Ave
Austintown, OH 44515-1621
Phone (330) 330-8655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250730000265 OH Practitioner - Mental Health Counselor 7517474968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

725 Boardman Canfield Rd
Suite L1
Boardman, OH 44512-4370
Phone (330) 330-8655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.2505493OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rajendra P Koirala, M.D., LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

16 Evans Ave
Youngstown, OH 44515
Phone (330) 330-8655

725 Boardman Canfield Rd
Ste L1
Youngstown, OH 44512
Phone (330) 330-8655

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": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1184261968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD STE L1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124370",
            "telephone_number": "330-330-8655",
            "fax_number": "330-330-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD STE L1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124370",
            "telephone_number": "330-330-8655",
            "fax_number": "330-330-8657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Evans Ave",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445151621",
            "country_code": "US",
            "telephone_number": "330-330-8655",
            "fax_number": "330-330-8657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURKIN",
        "first_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-29",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2505493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.