Individual provider Active NPI

Mary Boyette

  • Mental Health Counselor
  • Lynchburg, VA
National Provider Identifier
1417742560
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0717002389 Issued in VA
Practice address
1621 Enterprise Dr
Lynchburg, VA 24502-5797
Phone
(276) 237-4554
NPI assigned
Apr 10, 2025
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 0717002389 VA Primary

Addresses

Primary practice location

1621 Enterprise Dr
Lynchburg, VA 24502-5797

Mailing address

1621 Enterprise Dr
Lynchburg, VA 24502-5797

Other practice location 1

105 Cornerstone St Apt 103
Lynchburg, VA 24502-5447
Phone (276) 237-4554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250421000215 VA Practitioner - Marriage and Family Therapist 1153846480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patrick Henry Family Services OperationsGroup PAC ID 6103231444, 8 clinicians

Practice addresses (Care Compare)

1621 Enterprise Dr
Lynchburg, VA 24502-5797
Phone (434) 376-2006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick Henry Family Services Operations Mental Health CurrentSince Apr 15, 2025 Accepting new patients
Patrick Henry Boys and Girls Plantation, Inc CurrentSince Apr 13, 2025 Accepting new patients

Locations

1621 Enterprise Dr
Lynchburg, VA 24502
Phone (434) 285-0600

Organizations & group practices 2

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": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1417742560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 ENTERPRISE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245025797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 ENTERPRISE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245025797",
            "telephone_number": "276-237-4554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Cornerstone St Apt 103",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245025447",
            "country_code": "US",
            "telephone_number": "276-237-4554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYETTE",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0717002389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.