Individual provider Active NPI

Boris Abrams Haymson, PHD, LPCC, LADC

  • Mental Health Counselor
  • Savage, MN
National Provider Identifier
1689436461
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC00013 Issued in MN
Practice address
14473 Quebec Ave
Savage, MN 55378-2556
Phone
(952) 200-8262
NPI assigned
Jan 26, 2024
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303387 MN
Mental Health Counselor 101YM0800X CC00013 MN Primary
School Counselor 101YS0200X 507401 MN

Addresses

Primary practice location

14473 Quebec Ave
Savage, MN 55378-2556

Mailing address

14473 Quebec Ave
Savage, MN 55378-2556
Phone (952) 200-8262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240221001690 MN Practitioner - Mental Health Counselor 5799129458 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
303387MNMDAddiction (Substance Use Disorder) Counselor
CC00013MNMDMental Health Counselor
507401MNMDSchool Counselor
13MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2024 Accepting new patients

Locations

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1689436461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14473 QUEBEC AVE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782556",
            "telephone_number": "952-200-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14473 QUEBEC AVE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782556",
            "telephone_number": "952-200-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYMSON",
        "first_name": "BORIS",
        "middle_name": "ABRAMS",
        "credential": "PHD, LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303387",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00013",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MN",
            "license": "507401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

Verify at the official NPI Registry.