Sasha Venyke Bouldin, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P008998 Issued in NC

Practice address

3000 Highwoods Blvd Ste 301
Raleigh, NC 27604-1029

Phone

(919) 610-6284

NPI assigned

Jun 25, 2015

Last updated

Jun 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group NPD
• Hope Services, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1134420169
  Medicare reassignment NPD
• Hope Services, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1083938385
  NPD (past)

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1831571991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 TRINITY GATE LN APT 308",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073997",
            "telephone_number": "919-610-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HIGHWOODS BLVD STE 301",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041029",
            "telephone_number": "919-610-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULDIN",
        "first_name": "SASHA",
        "middle_name": "VENYKE",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gene Robert Botwright Jr.
• Natalie Rayne Boucher, MSW, LCSW
• Hossam Idrissi Boucteb
• Amanda N Boudreaux, MS, BCBA
• Alaa Bouhya
• Bryon Boulton, MD
• Lauren Maria Boulus, MS, RD, LDN
• Kathryn Boulware, LCSW
• Katelyn Bounds
• Katherine Marie Bounds, MSW, LCSW

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, 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 Jun 25, 2015; 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.

Verify at the official NPI Registry.