Vicky Ann Boettcher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1517-C Issued in AR

Practice address

701 Phillips PL
Huntsville, AR 72740-6266

Phone

(479) 750-2020

Fax

(479) 738-1132

NPI assigned

Jul 2, 2006

Sex

Female

Sole proprietor

No

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.

• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

• Vicky Ann Antell Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376572263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6430",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727666430",
            "telephone_number": "479-750-2020",
            "fax_number": "479-738-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PHILLIPS PL",
            "city": "HUNTSVILLE",
            "state": "AR",
            "postal_code": "727406266",
            "telephone_number": "479-750-2020",
            "fax_number": "479-738-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTCHER",
        "first_name": "VICKY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1517-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "5S978",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKY",
            "last_name": "ANTELL",
            "middle_name": "ANN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• B & H Operations Huntsville, LLC
• Danny Doyle Baker, LPC
• Angela Lorraine Boatright
• Elizabeth Grace Boaz
• Tulasi Bochula
• Boston Mountain Rural Health Center
• Boston Mountain Rural Health Center Inc
• Boston Mountain Rural Health Center, Inc
• Boston Mountain Rural Health Center, Inc
• Melissa K Brannan, M.S., LMFT

• All providers in Huntsville, AR
• Clinical Social Worker in Arkansas

• 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.