Individual provider Active NPI

Brandie Jean Boehmer, LCSW

  • Clinical Social Worker
  • Ocala, FL
National Provider Identifier
1891171278
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22616 Issued in FL
Practice address
8917 SW 50TH Ter
Ocala, FL 34476-6164
Phone
(507) 236-9569
Fax
(833) 959-1669
NPI assigned
Aug 7, 2015
Last updated
May 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22616 FL Primary
Clinical Social Worker 1041C0700X 111975 IA
Clinical Social Worker 1041C0700X 17786 MN

Addresses

Primary practice location

8917 SW 50TH Ter
Ocala, FL 34476-6164

Mailing address

8917 SW 50TH Ter
Ocala, FL 34476-6164
Phone (507) 236-9569

Other names 1

  • Brandie Jean Larson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160330001473 MN Practitioner - Clinical Social Worker 0143527531 Reassigns benefits to 1 organization
I20221005001323 IA Practitioner - Clinical Social Worker 0143527531

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Building Resilience Counseling LLCGroup PAC ID 2860862323, 2 clinicians

Practice addresses (Care Compare)

Saint James, MN 56081
Phone (507) 920-7878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22616FLMDClinical Social Worker
17786MNMDClinical Social Worker
111975IAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Building Resilience Counseling, LLC CurrentSince Jul 27, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1891171278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8917 SW 50TH TER",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766164",
            "telephone_number": "507-236-9569",
            "fax_number": "833-959-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8917 SW 50TH TER",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766164",
            "telephone_number": "507-236-9569",
            "fax_number": "833-959-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHMER",
        "first_name": "BRANDIE",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "22616",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "111975",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDIE",
            "last_name": "LARSON",
            "middle_name": "JEAN",
            "credential": "MSW, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.