Active NPI
Heather Lynn Jay-Boardman, L.S.W.
- Social Worker
- Mechanicsburg, PA
National Provider Identifier
1972540235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW-124655
- Practice address
- 960 Century Dr
Mechanicsburg, PA 17055-4374 - Phone
- (717) 795-0330
- Fax
- (717) 795-0407
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW-124655 | PA | Primary |
Addresses
Primary practice location
960 Century Dr
Mechanicsburg, PA 17055-4374
Mailing address
614 Saint Paul St
Lewisburg, PA 17837-1349
Phone (570) 522-9021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50053640 | Other | PA | CAPITAL BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW-124655 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1972540235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 SAINT PAUL ST",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178371349",
"telephone_number": "570-522-9021",
"fax_number": "570-524-9492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 CENTURY DR",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170554374",
"telephone_number": "717-795-0330",
"fax_number": "717-795-0407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAY-BOARDMAN",
"first_name": "HEATHER",
"middle_name": "LYNN",
"credential": "L.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-02",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW-124655",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50053640",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mechanicsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.