Individual provider Active NPI

Marla D Boehman, LCSW

  • Clinical Social Worker
  • Owensboro, KY
National Provider Identifier
1467569434
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3226 Issued in KY
Practice address
2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570
Phone
(270) 417-7980
Fax
(270) 417-7989
NPI assigned
Aug 24, 2006
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4249 KY
Clinical Social Worker 1041C0700X 3226 KY Primary

Addresses

Primary practice location

2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other identifiers 1

IdentifierTypeStateIssuer
7100286410MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
54.66 of 100Reported as group
Quality
21.7
Promoting interoperability
100
Improvement activities
0
Cost
74.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3226KYMDClinical Social Worker
4249KYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1467569434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR STE 409",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014570",
            "telephone_number": "270-417-7980",
            "fax_number": "270-417-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHMAN",
        "first_name": "MARLA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "4249",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100286410",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.