Healthcare Provider Details

I. General information

NPI: 1972092393
Provider Name (Legal Business Name): EMILY DAWN BOGGS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY CASTLE

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date: 08/11/2021
Reactivation Date: 08/25/2021

III. Provider practice location address

2727 S 3RD ST
IRONTON OH
45638-2760
US

IV. Provider business mailing address

2727 S 3RD ST
IRONTON OH
45638-2760
US

V. Phone/Fax

Practice location:
  • Phone: 740-534-2100
  • Fax:
Mailing address:
  • Phone: 740-534-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2106652
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: