Organization Active NPI

Boone Counseling Services, PLLC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1427302363
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BOONE COUNSELING SERVICES, PLLC
Practice address
314 Clifton Ave
Suite 200C
Minneapolis, MN 55403-3235
Phone
(612) 454-9798
Fax
(952) 487-5234
NPI assigned
Oct 30, 2012
Last updated
Jun 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Eric Francis Boone, LICSWNPI 1982702981
Title
Owner
Phone
(612) 454-9798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Clinical Social Worker 1041C0700X 10413 MN

Addresses

Primary practice location

314 Clifton Ave
Suite 200C
Minneapolis, MN 55403-3235

Mailing address

314 Clifton Ave Ste 200C
Minneapolis, MN 55403-3226
Phone (612) 454-9798

Other identifiers 1

IdentifierTypeStateIssuer
1982702981MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121116000374 MN Part B Supplier - Clinic/Group Practice 1759532955 Receives reassigned benefits from 1 practitioner
Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

314 Clifton Ave
Ste 200C
Minneapolis, MN 55403
Phone (612) 454-9798

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1427302363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 CLIFTON AVE STE 200C",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033226",
            "telephone_number": "612-454-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 CLIFTON AVE",
            "address_2": "SUITE 200C",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033235",
            "telephone_number": "612-454-9798",
            "fax_number": "952-487-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-454-9798",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10413",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982702981",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.