Active NPI
Brett Allen Boswinkle, LMHC, CSAYC
- Mental Health Counselor
- Marion, IN
National Provider Identifier
1376849299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39002354A
- Practice address
- 101 S Washington St
Marion, IN 46952-3867 - Phone
- (765) 662-9971
- Fax
- (765) 651-6563
- NPI assigned
- Feb 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39002354A | IN | Primary |
Addresses
Primary practice location
101 S Washington St
Marion, IN 46952-3867
Mailing address
101 S Washington St
Marion, IN 46952-3867
Phone (765) 662-9971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100124250 | Medicaid | IN |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39002354A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1376849299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S WASHINGTON ST",
"city": "MARION",
"state": "IN",
"postal_code": "469523867",
"telephone_number": "765-662-9971",
"fax_number": "765-651-6563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S WASHINGTON ST",
"city": "MARION",
"state": "IN",
"postal_code": "469523867",
"telephone_number": "765-662-9971",
"fax_number": "765-651-6563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSWINKLE",
"first_name": "BRETT",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "LMHC, CSAYC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-10",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39002354A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100124250",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.