Active NPI
Michelle M Boze, PSY.D.
- Clinical Child & Adolescent Psychologist
- Mandeville, LA
National Provider Identifier
1750421608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 891
- Practice address
- 2140 8TH St Ste C
Mandeville, LA 70471-1924 - Phone
- (985) 327-0400
- Fax
- (985) 231-6733
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 891 | LA | Primary |
Addresses
Primary practice location
2140 8TH St Ste C
Mandeville, LA 70471-1924
Mailing address
PO Box 1536
Mandeville, LA 70470-1536
Phone (985) 635-6943
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891 | Other | LA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 891 | LA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1750421608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1536",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704701536",
"telephone_number": "985-635-6943",
"fax_number": "985-231-6733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 8TH ST STE C",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704711924",
"telephone_number": "985-327-0400",
"fax_number": "985-231-6733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZE",
"first_name": "MICHELLE",
"middle_name": "M",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2024-01-09",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "LA",
"license": "891",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "891",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.