Individual provider Active NPI

Christie Lee Bogle, LGPC

  • Mental Health Counselor
  • Largo, MD
National Provider Identifier
1417440207
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP5734 Issued in MD
Practice address
1300 Mercantile LN Ste 129-32
Largo, MD 20774-5327
Phone
(850) 279-5499
NPI assigned
Jun 7, 2018
Last updated
Jun 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP5734 MD Primary

Addresses

Primary practice location

1300 Mercantile LN Ste 129-32
Largo, MD 20774-5327

Mailing address

1300 Mercantile LN Ste 129-32
Largo, MD 20774-5327
Phone (850) 279-5499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814002856 DC Practitioner - Mental Health Counselor 4284133562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2196 3Rd Ave
New York, NY 10035-3501

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP5734MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jul 1, 2025 Accepting new patients

Locations

1140 3rd St NE
Washington, DC 20002
Phone (202) 935-1033

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

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.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1417440207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 129-32",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "850-279-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 129-32",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "850-279-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGLE",
        "first_name": "CHRISTIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP5734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.