MEDICARE: WENDY BOGGS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0701015282	VA

General Provider Information

NPI Number	:	1558252007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY BOGGS

Provider Business Mailing Address
First Line	:	7489 RIGHT FLANK RD STE 330
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-3845
Country	:	US
Telephone Number	:	804-398-8401
Fax Number	:

Provider Business Practice Location Address
First Line	:	6366 MECHANICSVILLE TPKE STE 203
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-4704
Country	:	US
Telephone Number	:	804-398-8401
Fax Number	:	804-789-8881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	08/26/2025

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