Individual provider Active NPI

Emma Boateng

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
National Provider Identifier
1740936780
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024183745 Issued in VA
Practice address
14623 Aurora Dr
Woodbridge, VA 22193-1231
Phone
(571) 309-1619
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024183745 VA Primary

Addresses

Primary practice location

14623 Aurora Dr
Woodbridge, VA 22193-1231

Mailing address

14623 Aurora Dr
Woodbridge, VA 22193-1231
Phone (571) 309-1619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220726000584 VA Practitioner - Nurse Practitioner 0941681712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

2501 Hunter PL
Suite 202
Woodbridge, VA 22192-3940
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024183745VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Wellness LLC Psychiatric/Mental Health CurrentSince Apr 16, 2024 Accepting new patients
Thrive Counseling LLC CurrentSince Jun 20, 2022 Accepting new patients
Virginia Center for Psychological Services PLLC Past Accepting new patients

Locations

5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498

2501 Hunter Pl
Ste 202
Woodbridge, VA 22192
Phone (304) 940-9724

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1740936780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14623 AURORA DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931231",
            "telephone_number": "571-309-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14623 AURORA DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931231",
            "telephone_number": "571-309-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATENG",
        "first_name": "EMMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024183745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.