Julieann Ingberg Boertje, LMFT,RN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1916 Issued in MN

Practice address

510 Long St
Suite 101
Mankato, MN 56001-4397

Phone

(507) 625-4884

Fax

(507) 625-6311

NPI assigned

Mar 18, 2010

Last updated

Jun 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Law, Registered Nurse

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.

• Mankato Marriage and Family Therapy Center PLC

  • Mental Health Counselor
  • Mankato, MN
  • NPI 1689990665
  NPD

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276992000000",
    "number": "1902120074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53032 220TH ST",
            "city": "WELLS",
            "state": "MN",
            "postal_code": "560976115",
            "telephone_number": "507-340-5604",
            "fax_number": "507-553-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 LONG ST",
            "address_2": "SUITE 101",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014397",
            "telephone_number": "507-625-4884",
            "fax_number": "507-625-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERTJE",
        "first_name": "JULIEANN",
        "middle_name": "INGBERG",
        "credential": "LMFT,RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1916",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R91359-5",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kay Blume, MS, CCC-SLP
• Debra Ann Bobendrier, D.C.
• Bodikey Physical Therapy, LLC
• Sally Bodlovick
• Lindsey Elaine Boerger
• Emily Elizabeth Boettcher
• Kelly Ann Boettcher
• Taylor Marie Boettcher
• Robert Matthew Boisseau, AG-ACNP
• Trudy Boleen

• Marriage & Family Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.