NPIMap

Individual provider Active NPI

Ivory Boston, LMSW

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1306576491
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
42295 Issued in ID
Practice address
148 S Cole Rd
Boise, ID 83709-0932
Phone
(208) 683-8320
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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 42295 ID Primary

Addresses

Primary practice location

148 S Cole Rd
Boise, ID 83709-0932

Mailing address

148 S Cole Rd
Boise, ID 83709-0932
Phone (208) 683-8320

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL BestNoted Direct

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

LicenseStateTypeSpecialty
42295IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Jun 21, 2022 Accepting new patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Jun 21, 2022 Accepting new patients
Thomason Counseling Services Past Accepting new patients

Locations

148 S Cole Rd
Boise, ID 83709
Phone (208) 683-8320

Organizations & group practices 3

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1306576491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 S COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090932",
            "telephone_number": "208-683-8320",
            "fax_number": "208-969-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090932",
            "telephone_number": "208-683-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "IVORY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "42295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BestNoted",
            "affiliation": "N",
            "endpointDescription": "Electronic health care portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "148 S Cole Rd",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837090932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.

Verify at the official NPI Registry.