Antoinette Bogan

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

610 Old York Rd
Jenkintown, PA 19046-2837

Phone

(215) 820-3235

Fax

(844) 605-1833

NPI assigned

Mar 14, 2017

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

Enrolled in PA

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

Medicare enrollment (NPD)

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.

• Gentle Force Counseling Services

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jenkintown, PA
  • NPI 1073128690

  Mental Health

  Medicare reassignment NPD Authorized official
• Gentle Force Counseling Services

  • Mental Health Counselor
  • Jenkintown, PA
  • NPI 1619645173

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Gentle Force Wellness Treatment Facility, Inc

  • Mental Health Counselor
  • Philadelphia, PA
  • NPI 1700656774
  NPD Authorized official

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1265973978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 OLD YORK ROAD",
            "address_2": "SUITE 400",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190468406",
            "telephone_number": "215-820-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 OLD YORK RD",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462837",
            "telephone_number": "215-820-3235",
            "fax_number": "844-605-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "ANTOINETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice N Block, LCSW
• Blue Ribbon Homecare LLC
• Jenna Nicole Blum, PSYD
• Ronald M Blum, DO
• Kelsey Nicole Boff
• Kathleen M Boland, RN
• Davida Hudson Bolger, LPC
• Bond Medical Services LLC
• Jessica Bonner, LPC
• Paula A Bononi, MD

• Addiction (Substance Use Disorder) Counselor in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Addiction (Substance Use Disorder) Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.