Active NPI
Marla D Boehman, LCSW
- Clinical Social Worker
- Owensboro, KY
National Provider Identifier
1467569434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3226
- 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, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100286410 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 54.66 of 100
- Quality
- 21.7
- Promoting interoperability
- 100
- Improvement activities
- 0
- Cost
- 74.95
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3226 | KY | MD | Clinical Social Worker |
| 4249 | KY | MD | Speech-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.