Irving Boone, PH.D

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

300575 Issued in MN

Practice address

1010 University Ave W
Saint Paul, MN 55104-4746

Phone

(651) 659-0359

Fax

(651) 645-1688

NPI assigned

Jun 29, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1457589467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 LAWSON AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551063328",
            "telephone_number": "651-216-5774",
            "fax_number": "651-645-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044746",
            "telephone_number": "651-659-0359",
            "fax_number": "651-645-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "300575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.