Jasper M Boomer, LSATP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0718000456 Issued in VA

Practice address

4229 Lafayette Ctr Dr Ste 1675
Chantilly, VA 20151-1270

Phone

(855) 326-4673

NPI assigned

Feb 8, 2022

Last updated

Feb 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rivers of Hope Counseling Center LLC

  dba The Rivers of Hope Counseling Center LLC

  • Mental Health Counselor
  • Chantilly, VA
  • NPI 1922607977
  NPD

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1679227623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 LAFAYETTE CTR DR STE 1675",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511270",
            "telephone_number": "855-326-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 LAFAYETTE CTR DR STE 1675",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511270",
            "telephone_number": "855-326-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOMER",
        "first_name": "JASPER",
        "middle_name": "M",
        "credential": "LSATP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluebird Care Mobility LLC (Bluebird Medical Transport Services)
• Brian Bok
• Madhulika Gupta Boland, PH.D.
• Amanie Bonchu
• Shannon Clarke Bond-Young, LPC-R
• Cherri Boothe, LPC
• Kevin Boss, LAT, ATC
• Hakima Bouhouch, MD
• Claire Bowers, LCSW
• Diane Lynn Brace, M.S.W., L.C.S.W.

• Addiction (Substance Use Disorder) Counselor in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.