Individual provider Active NPI

Dorothy L Boston, PSY.D.

  • Clinical Psychologist
  • Gallipolis Ferry, WV
National Provider Identifier
1679801278
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
749 Issued in WV
Practice address
15167 Huntington Rd
Gallipolis Ferry, WV 25515-6615
Phone
(304) 675-5725
Fax
(304) 675-5727
NPI assigned
Nov 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6843 OH
Clinical Psychologist 103TC0700X 749 WV Primary

Addresses

Primary practice location

15167 Huntington Rd
Gallipolis Ferry, WV 25515-6615

Mailing address

2585 3Rd Ave
Huntington, WV 25703-1642
Phone (304) 697-1396

Other practice location 1

2801 Jackson Ave
Point Pleasant, WV 25550-1713
Phone (304) 675-4107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20160815001403 WV Practitioner - Clinical Psychologist 0547423790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Health Systems, IncGroup PAC ID 9931017969, shared by 41 NPIs, 110 clinicians

Practice addresses (Care Compare)

2501 Jackson Ave
Point Pleasant, WV 25550-2035
Phone (304) 857-0004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6843OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc CurrentSince Aug 8, 2016 Accepting new patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc CurrentSince Oct 19, 2024 Accepting new patients

Locations

26489 Huntington Rd
Apple Grove, WV 25502
Phone (304) 675-5725

2585 3rd Ave
Huntington, WV 25703
Phone (304) 697-1396

2801 Jackson Ave
Pt Pleasant, WV 25550
Phone (304) 675-4107

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1679801278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15167 HUNTINGTON RD",
            "city": "GALLIPOLIS FERRY",
            "state": "WV",
            "postal_code": "255156615",
            "telephone_number": "304-675-5725",
            "fax_number": "304-675-5727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Point Pleasant",
            "state": "WV",
            "postal_code": "255501713",
            "country_code": "US",
            "telephone_number": "304-675-4107",
            "fax_number": "304-675-4233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "DOROTHY",
        "middle_name": "L",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6843",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis Ferry, WV

Sources for this page

Verify at the official NPI Registry.