Mary Flynn Boener, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 8577 Issued in FL

Practice address

1340 Ridgewood Ave
Holly Hill, FL 32117-2320

Phone

(386) 676-7175

Fax

(386) 676-7134

NPI assigned

Jan 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Catherine Flynn Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christopher Dennis MD PLLCGroup PAC ID 7416254990, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christopher Dennis MD PLLC

  • Psychiatry Physician
  • Johns Creek, GA
  • NPI 1588090229

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1669742474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 RIDGEWOOD AVE",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321172320",
            "telephone_number": "386-676-7175",
            "fax_number": "386-676-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 RIDGEWOOD AVE",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321172320",
            "telephone_number": "386-676-7175",
            "fax_number": "386-676-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENER",
        "first_name": "MARY",
        "middle_name": "FLYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FLYNN",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beacon of Life Florida LLC
• Shirley Beard, COTA
• Tashena Beckford-NG
• Karen Michelle Berkeley, LCSW
• BG SNF Opco LLC
• Richard Lee Braithwaite, M.D.
• Georgia Mae Brazzell
• Jared Brooks, PHARMD
• Sharon Ann Calcutt
• Jean S Caron, DOM, AP, LMT

• Clinical Social Worker in Holly Hill, FL
• Providers in Holly Hill, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.