Boonmee Pakviset Edwards, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25675 Issued in MN

Practice address

4600 18TH Ave NW
Rochester, MN 55901-2116

Phone

(507) 287-2010

Fax

(507) 287-7805

NPI assigned

Aug 20, 2019

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

Other names 1

• Boonmee Pakviset Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Family Service Rochester, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester, MN
  • NPI 1275746083
  NPD

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1912554403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 18TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012116",
            "telephone_number": "507-287-2010",
            "fax_number": "507-287-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 18TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012116",
            "telephone_number": "507-287-2010",
            "fax_number": "507-287-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKVISET EDWARDS",
        "first_name": "BOONMEE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOONMEE",
            "last_name": "PAKVISET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Kristine Pahapill, MD
• Priya Kalsank Pai, MBBS
• Peter C Pairolero, M.D.
• Alexander Brighton Pais, MD
• Sujaytha Subhash Paknikar, MD
• Jeeva Palanisamy, MD
• Daniel Seth Paley, M.D.
• John F Pallanch, M.D.
• Sindhuja Palle, MBBS
• Lindsey Shannon Palm-Vlasak, MD, PHD

• Clinical Social Worker in Rochester, MN
• Providers in Rochester, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.