Active NPI
Caryl Boehnert, PH.D.
- Clinical Psychologist
- Eureka, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP4290
- Practice address
- 2412 Buhne St
Eureka, CA 95501-3207 - Phone
- (707) 441-1624
- Fax
- (707) 441-1253
- NPI assigned
- Jul 10, 2008
- Last updated
- Jul 10, 2008
- 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 Psychologist | 103TC0700X | LP4290 | MN | Primary |
Addresses
Primary practice location
2412 Buhne St
Eureka, CA 95501-3207
Mailing address
670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
18205 45TH Ave N
Plymouth, MN 55446-4551
Phone (763) 400-7828
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4290 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott M Yarosh, LLC | Current | Accepting new patients | |
| Healthwise Psychology, PA | Clinical | Current | Accepting new patients |
| Bridge Medical Supply, Inc. | Past | Accepting new patients | |
| University of Minnesota Physicians | Past | Accepting new patients | |
| Open Door Community Health Centers | Past | Accepting new patients | |
| University of Minnesota Physicians | Past | Accepting new patients |
Locations
11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828
18205 45th Ave N
Plymouth, MN 55446
Phone (763) 400-7828
Organizations & group practices 6
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.
-
- Clinical Psychologist
- Maple Grove, MN
- NPI 1184920753
-
- Mental Health Counselor
- Saint Paul, MN
- NPI 1144543265
-
dba Open Door Downtown
- Federally Qualified Health Center (FQHC)
- Eureka, CA
- NPI 1831713452
-
- Durable Medical Equipment & Medical Supplies
- Minneapolis, MN
- NPI 1245504489
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
-
dba Dental Clinic
- Dental Clinic/Center
- Minneapolis, MN
- NPI 1952546061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215648000000",
"number": "1780848515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 9TH ST",
"address_2": "SUITE 203",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216248",
"telephone_number": "707-826-8633",
"fax_number": "707-826-8638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2412 BUHNE ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013207",
"telephone_number": "707-441-1624",
"fax_number": "707-441-1253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHNERT",
"first_name": "CARYL",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-10",
"last_updated": "2008-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.