Active NPI
Mary Lynn Boatwright, LPC; LMFT
- Mental Health Counselor
- Dickinson, TX
National Provider Identifier
1407969975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 16477
- Practice address
- 2401 Termini St
Suite C
Dickinson, TX 77539-4995 - Phone
- (409) 938-4814
- Fax
- (409) 938-4849
- NPI assigned
- Aug 17, 2006
- Last updated
- Dec 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 16477 | TX | Primary |
| Marriage & Family Therapist | 106H00000X | 004982-041969 | TX |
Addresses
Primary practice location
2401 Termini St
Suite C
Dickinson, TX 77539-4995
Mailing address
2200 Market St
Suite 600
Galveston, TX 77550-1530
Phone (409) 762-8636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15611020-3 | Medicaid | TX |
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 |
|---|---|---|---|
| 16477 | TX | MD | Mental Health Counselor |
| 004982-041969 | TX | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Service Center of Galveston County, Texas | Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Galveston, TX
- NPI 1902871833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1407969975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 MARKET ST",
"address_2": "SUITE 600",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775501530",
"telephone_number": "409-762-8636",
"fax_number": "409-762-4185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 TERMINI ST",
"address_2": "SUITE C",
"city": "DICKINSON",
"state": "TX",
"postal_code": "775394995",
"telephone_number": "409-938-4814",
"fax_number": "409-938-4849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOATWRIGHT",
"first_name": "MARY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LPC; LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "16477",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "004982-041969",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15611020-3",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dickinson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.