Boss Inner Child Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BOSS INNER CHILD COUNSELING, LLC

Practice address

14203 Old Courthouse Way
Suite B
Newport News, VA 23602

Phone

(757) 893-0321

NPI assigned

May 20, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Ingrid Marie Bornia, LCSW, BCD

Title

Owner and Ceo

Phone

(757) 893-0321

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1962069526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLISEUM CROSSING",
            "address_2": "#138",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665962",
            "telephone_number": "757-893-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14203 OLD COURTHOUSE WAY",
            "address_2": "SUITE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23602",
            "telephone_number": "757-893-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSS INNER CHILD COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "BORNIA",
        "authorized_official_first_name": "INGRID",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "757-893-0321",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, BCD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassianne Summerlin Booth, PH.D.
• Lindsay Elizabeth Borden, M.D.
• Mary Margaret Borer, M.D.
• Gabrielle Jacenea Louise Bosch
• Taylor Boseman
• David Christopher Bosworth, MD
• Nizar Bou Diab, MD
• Freda Bouchelaghem, LCSW
• Lee Kelly Bowditch, L.P.C.
• Natalie Suzanne Bowen, M.S., CCC-SLP

• Community/Behavioral Health Agency in Newport News, VA
• Providers in Newport News, VA by specialty
• Community/Behavioral Health Agency in Virginia

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