Deric J. Boston, LCSW

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C006078 Issued in NC

Legal business name

DERIC J. BOSTON, LCSW

Practice address

1058 W Club Blvd
Box 642
Durham, NC 27701-1104

Phone

(919) 619-1032

NPI assigned

Jul 11, 2008

Organization subpart

No

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

Authorized official

Name

Deric Boston, LCSW

Title

Owner

Phone

(919) 619-1032

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1891959524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 W CLUB BLVD",
            "address_2": "STE 615",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277011104",
            "telephone_number": "919-619-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 W CLUB BLVD",
            "address_2": "BOX 642",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277011104",
            "telephone_number": "919-619-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERIC J. BOSTON, LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "BOSTON",
        "authorized_official_first_name": "DERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-619-1032",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C006078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610643",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Justine Depietro
• Adam Deprimo, MS, OTR/L
• Tatyana Der, MD
• Linda Ruth Derbes, M.D.
• Connor Deri, PHARMD
• Christopher Dermarkarian, M.D.
• Evelyn Deroche, CRNA
• Melissa Derosier, PHD
• Anne Lynn Derouin, R.N.
• Bruce James Derrick, M.D.

• Community/Behavioral Health Agency in Durham, NC
• Providers in Durham, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.