Individual provider Active NPI

Bob Boivin, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Marquette, MI
National Provider Identifier
1306361274
Registry record updated Aug 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
241 Wright St
Marquette, MI 49855-1955
Phone
(906) 228-7611
NPI assigned
Aug 11, 2017
Last updated
Aug 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

241 Wright St
Marquette, MI 49855-1955

Mailing address

2058 Van Evera Ave
Marquette, MI 49855-1851

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

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502409600000",
    "number": "1306361274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 VAN EVERA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498551851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 WRIGHT ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498551955",
            "telephone_number": "906-228-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOIVIN",
        "first_name": "BOB",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-11",
        "last_updated": "2017-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; 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.