Individual provider Active NPI

Luke Boardman

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1245863364
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC10757 Issued in MD
Practice address
2 Hamill Rd Ste 332
Baltimore, MD 21210-1813
Phone
(443) 266-2270
NPI assigned
Feb 17, 2020
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC10757 MD Primary

Addresses

Primary practice location

2 Hamill Rd Ste 332
Baltimore, MD 21210-1813

Mailing address

2 Hamill Rd Ste 332
Baltimore, MD 21210-1813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20241010004046 MD Practitioner - Mental Health Counselor 2062944358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Soup Counseling, LLC CurrentSince Sep 13, 2024 Accepting new patients
Stone Soup Counseling, LLC Professional CurrentSince Sep 13, 2024 Accepting new patients

Locations

2 Hamill Rd
Ste 332
Baltimore, MD 21210
Phone (443) 266-2270

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1245863364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HAMILL RD STE 332",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HAMILL RD STE 332",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101813",
            "telephone_number": "443-266-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "LUKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC10757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.