Stephen John Boose, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

107917 Issued in NY

Practice address

939 Johnson Ave
Ronkonkoma, NY 11779-6066

Phone

(631) 471-7242

NPI assigned

Apr 7, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/77c2b089-5ae8-473f-98a4-de9173e168aa/

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.

• Association for Mental Health and Wellness Inc

  • Community/Behavioral Health Agency
  • Ronkonkoma, NY
  • NPI 1578516738
  NPD

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1366071730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 BARTON AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721401",
            "telephone_number": "631-255-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 JOHNSON AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796066",
            "telephone_number": "631-471-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOSE",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pat Bivona
• Amanda Ashley Bodendorf, MSW
• Bohemia Medical, PC
• Lissa Boileau
• Frank William Bonnici, CEP
• Ted Borkstrom, CASAC
• Tara Botter, RN
• Bottizer Radiological PC
• Maryanne Bounaparte, LMT
• Tailer Boutin

• Social Worker in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.