Boundless Innovations for Holistc Living

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MH62 Issued in MD

Legal business name

BOUNDLESS INNOVATIONS FOR HOLISTC LIVING

Practice address

1500 Union Avenue
Suite 117
Baltimore, MD 21211-1975

Phone

(410) 904-2412

Fax

(443) 817-0731

NPI assigned

Apr 15, 2013

Last updated

Jun 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea J FoxworthNPI 1477794790

Title

Authorized Official

Phone

(443) 562-0605

Specialties & licenses 1

Addresses

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.

• Andrea Jawon Foxworth, LCPC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1477794790
  NPD Authorized official

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1437592938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 1/2 KENT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212074829",
            "telephone_number": "443-904-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 UNION AVENUE",
            "address_2": "SUITE 117",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111975",
            "telephone_number": "410-904-2412",
            "fax_number": "443-817-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNDLESS INNOVATIONS FOR HOLISTC LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "FOXWORTH",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "443-562-0605"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "MH62",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Boulden
• Travis S Bouldin
• Kelsey Ayne Boulier, MS, LAT, ATC
• Leigh Ebony Boulware, M.D.
• Natalie J Boulware, NATUROPATH
• Matthew S Bourdeau, PT
• Denis Lee Bourke, M.D.
• Mohammad Bourmaf
• Paige R Bourne, DPT
• Douglas Michael Bourque, MD

• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.