Anne L. Boedecker, PHD

Individual provider Active NPI Clinical Psychologist · Bow, NH

NPI 1376558288 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376558288
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
248 (NH)
Practice address
4 Clearview Dr
Bow, NH 03304-3612
Phone
(603) 226-2230
Fax
(603) 224-0278
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
248NHMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Health Management Inc Clinical Past
since Jul 3, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 248 NH Yes

Addresses

Primary practice location

4 Clearview Dr
Bow, NH 03304-3612

Mailing address

4 Clearview Dr
Bow, NH 03304-3612
Phone (603) 226-2230

Other identifiers

IdentifierTypeStateIssuer
80008498MedicaidNH

Other providers in Bow, NH

All providers in Bow, NH · Clinical Psychologist in New Hampshire

Sources for this page

Verify at the official NPI Registry.