Individual provider Active NPI

Eve R H Boden, MSW LCSW

  • Clinical Social Worker
  • Syosset, NY
National Provider Identifier
1346396835
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R019005 Issued in NY
Practice address
32 Sexton Rd
Syosset, NY 11791-6610
Phone
(516) 938-7770
Fax
(516) 433-8967
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R019005 NY Primary

Addresses

Primary practice location

32 Sexton Rd
Syosset, NY 11791-6610

Mailing address

32 Sexton Rd
Syosset, NY 11791-6610
Phone (516) 938-7770

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R019005NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346396835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SEXTON RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117916610",
            "telephone_number": "516-938-7770",
            "fax_number": "516-433-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SEXTON RD",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117916610",
            "telephone_number": "516-938-7770",
            "fax_number": "516-433-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODEN",
        "first_name": "EVE",
        "middle_name": "R H",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R019005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.