Kimberly Marie Boeke, PSYD
Individual provider Active NPI Clinical Psychologist · Maynard, MA
NPI 1467985457 · NPPES record last updated Oct 11, 2025
Key facts
- NPI
- 1467985457
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0810005673 (VA)
- Practice address
- 141 Parker St
Maynard, MA 01754-2178 - Phone
- (866) 991-2103
- NPI assigned
- Apr 6, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri Area Community Health
Practice addresses (Care Compare)
40 Wiley Dr
Ferrum, VA 24088-1100
Phone (540) 365-4469
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170605002658 | VA | Practitioner - Clinical Psychologist | 6901173491 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005673 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri Area Community Health | Current | Accepting new patients |
Locations
180 Ferrum Mountain Rd
Ferrum, VA 24088
Phone (540) 365-4469
140 Christiansburg Pike NE
Floyd, VA 24091
Phone (540) 745-9290
14558 Danville Pike
Laurel Fork, VA 24352
Phone (276) 398-1200
14558 Danville Pike
#9
Laurel Fork, VA 24352
Phone (540) 398-2292
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0810005673 | VA | |
| Clinical Psychologist | 103TC0700X | 0810005673 | VA | Yes |
Addresses
Primary practice location
141 Parker St
Maynard, MA 01754-2178
Mailing address
2550 Waterview Dr Unit 152
Northbrook, IL 60062-6349
Phone (815) 236-4941
Other practice location 1
180 Ferrum Mountain Rd
Ferrum, VA 24088-2939
Phone (540) 365-4469
Other practice location 2
140 Christiansburg Pike NE
Floyd, VA 24091-3742
Phone (540) 745-9290
Other practice location 3
15301 Warren Shingle Rd
Beale AFB, CA 95903-1905
Phone (530) 634-3420
Other providers in Maynard, MA
- Balanced Mind & Wellness
- Morgan Olympia Baldwin
- Adriane Barrera
- Benjamin Roth DMD PLLC
- Courtney Berens
- Monica Bolton
- Melinda Bowens
- Brain Body Synergy LLC
- Wendy Anne Calender
- Robert R Cassidy
All providers in Maynard, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.