Rebecca E. Boardman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CP00942740 Issued in WV

Practice address

511 Morris St
Charleston, WV 25301-1326

Phone

(304) 341-0511

Fax

(304) 341-0499

NPI assigned

May 5, 2014

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1942610522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 GREENBRIER ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253119623",
            "telephone_number": "304-344-5924",
            "fax_number": "304-356-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-341-0511",
            "fax_number": "304-341-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "REBECCA",
        "middle_name": "E.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "CP00942740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005355002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Hines Blue, LPC
• Joseph Michael Blumer, D.O.
• Steven Bly
• Meghan Nicole Board
• Carla Boardman, RN
• Traci Boardman
• Cheyenne Boatright
• Cydnie Ann Boddy
• John Bodkin III, DO
• Body Tranquil LLC

• Clinical Social Worker in Charleston, WV
• Providers in Charleston, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.