Individual provider Active NPI

Ryan Nolan Bloxham, LMHC

  • Mental Health Counselor
  • Boston, MA
National Provider Identifier
1730848508
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC10005171 Issued in MA
Practice address
575 Boylston St FL 2W
Boston, MA 02116-3607
Phone
(617) 354-4450
NPI assigned
Dec 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC10005171 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

575 Boylston St FL 2W
Boston, MA 02116-3607

Mailing address

575 Boylston St FL 2W
Boston, MA 02116-3607
Phone (617) 354-4450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260310001322 MA Practitioner - Mental Health Counselor 6103309026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

575 Boylston St
Suite 2
Boston, MA 02116-3607
Phone (617) 354-4450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMHC10005171MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince May 1, 2026 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince May 1, 2026 Accepting new patients

Locations

575 Boylston St
Ste 2
Boston, MA 02116
Phone (617) 675-1700

Organizations & group practices 2

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": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1730848508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 BOYLSTON ST FL 2W",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163607",
            "telephone_number": "617-354-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 BOYLSTON ST FL 2W",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163607",
            "telephone_number": "617-354-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOXHAM",
        "first_name": "RYAN",
        "middle_name": "NOLAN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-09",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10005171",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.