Individual provider Active NPI

Rebecca N Boedges, MS, MS, LCMHC

  • Mental Health Counselor
  • Burlington, VT
National Provider Identifier
1366720609
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068.0069445 Issued in VT
Practice address
1 Church St FL 3
Burlington, VT 05401-4451
Phone
(802) 489-6701
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 068.0069445 VT Primary

Addresses

Primary practice location

1 Church St FL 3
Burlington, VT 05401-4451

Mailing address

1 Church St FL 3
Burlington, VT 05401-4451
Phone (802) 489-6701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 19, 2024 through May 19, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
068.0069445VTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366720609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHURCH ST FL 3",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014451",
            "telephone_number": "802-489-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHURCH ST FL 3",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014451",
            "telephone_number": "802-489-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEDGES",
        "first_name": "REBECCA",
        "middle_name": "N",
        "credential": "MS, MS, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0069445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.