Blue Gregory Boyer, BA, CADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Waterloo, IA
NPI 1831693290 · NPPES record last updated Jul 3, 2018
Key facts
- NPI
- 1831693290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 18031 (IA)
- Practice address
- 3362 University Ave.
Waterloo, IA 50701 - Phone
- (319) 235-6571
- Fax
- (319) 235-6028
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3362 University Ave
Waterloo, IA 50701-2006
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18031 | IA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways Behavioral Services Inc | Addiction (Substance Use Disorder) | Past | Accepting new patients |
| Pathways Behavioral Services, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18031 | IA | Yes |
Addresses
Primary practice location
3362 University Ave.
Waterloo, IA 50701
Mailing address
3362 University Ave
Waterloo, IA 50701-2006
Phone (319) 235-6571
Other providers in Waterloo, IA
- Cara Beth Boubin
- Brian Lee Bouck
- Mary Kathryn Bowen
- Kathi K Bower
- Dieter J Boxmann
- Boyle Counseling & Consulting LLC
- Cynthia Renee Boyle
- Robert Bryan Boyle
- Crystal Boyles
- Michaella Braamse
All providers in Waterloo, IA · Addiction (Substance Use Disorder) Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.