Scott Mathew Boiallis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008920 Issued in NC

Practice address

300 Veazey Dr
Butner, NC 27509-1668

Phone

(919) 764-7102

NPI assigned

Jan 16, 2012

Last updated

Jan 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1326672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1750652269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-5630",
            "fax_number": "919-764-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-7102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Skimmer Ln",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "NY",
            "postal_code": "117562007",
            "country_code": "US",
            "telephone_number": "516-579-3642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 Aubaun Way",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456061",
            "country_code": "US",
            "telephone_number": "516-578-4178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOIALLIS",
        "first_name": "SCOTT",
        "middle_name": "MATHEW",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-16",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084072",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Cates Houston Bevier, PHARMD
• Carillon Bihlmeyer, LCSW
• Catharine G Black, LCSW
• Ashley Stephens Blake, LCSW
• Nanzette Jarmond Blount, B.S.W.,M.ED.
• Robert Bryan Bomberg, M.D.
• Mack Bonner, M.D.
• Umit Borkan-Sevim, DDS
• Noa Borkan, RD
• Marta Renee Bowen, M.D.

• Clinical Social Worker in Butner, NC
• Providers in Butner, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.