Individual provider Active NPI

Katelyn M Boggs

  • Addiction (Substance Use Disorder) Counselor
  • South Point, OH
National Provider Identifier
1396410122
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
186859 Issued in OH
Practice address
520 Solida Rd
South Point, OH 45680-9347
Phone
(740) 523-0097
Fax
(740) 523-0049
NPI assigned
Aug 13, 2021
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 177495 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 186859 OH Primary

Addresses

Primary practice location

520 Solida Rd
South Point, OH 45680-9347

Mailing address

520 Solida Rd
South Point, OH 45680-9347
Phone (740) 523-0097

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

LicenseStateTypeSpecialty
177495OHMDAddiction (Substance Use Disorder) Counselor
186859OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Regal Recovery Care, LLC CurrentSince Sep 23, 2024 Accepting new patients
Regal Recovery Care, LLC CurrentSince Sep 23, 2024 Accepting new patients
Scioto Family and Behavioral Medicine Addiction (Substance Use Disorder) PastSince Aug 8, 2021 Accepting new patients

Locations

520 Solida Rd
South Point, OH 45680
Phone (740) 523-0097

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1396410122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SOLIDA RD",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456809347",
            "telephone_number": "740-523-0097",
            "fax_number": "740-523-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SOLIDA RD",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456809347",
            "telephone_number": "740-523-0097",
            "fax_number": "740-523-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "KATELYN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "177495",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "186859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Point, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.