Katelyn Boles, LPC in Wynne, AR - Medicare Counselor Provider

Katelyn Boles, LPC is a medicare enrolled "Counselor - Mental Health" provider in Wynne, Arkansas. Her current practice location is 206 Levesque Ave E, Wynne, Arkansas. You can reach out to her office (for appointments etc.) via phone at (870) 351-0312.

Katelyn Boles is licensed to practice in Arkansas (license number P1904050) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265980593.

Contact Information

	Katelyn Boles, LPC
	206 Levesque Ave E, Wynne, AR 72396-2938
	(870) 351-0312
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Katelyn Boles
Gender	Female
Speciality	Counselor - Mental Health
Location	206 Levesque Ave E, Wynne, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265980593
Provider Enumeration Date: 09/15/2016
Last Update Date: 10/21/2024

Medicare PECOS Information:

PECOS PAC ID: 9537503867
Enrollment ID: I20240215001257

Medical Identifiers

Medical identifiers for Katelyn Boles such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265980593	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	A1609114 (Arkansas)	Secondary
101YM0800X	Counselor - Mental Health	P1904050 (Arkansas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Katelyn Boles allows following entities to bill medicare on her behalf.

Entity Name	Changes Behavioral Health, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114260486 PECOS PAC ID: 6103149653 Enrollment ID: O20150108001118

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Katelyn Boles is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Katelyn Boles, LPC 10 County Road 367, Wynne, AR 72396-8079 Ph: (703) 510-3128	Katelyn Boles, LPC 206 Levesque Ave E, Wynne, AR 72396-2938 Ph: (870) 351-0312

Reviews and Comments

Counselor in Wynne, AR

Mrs. Millie F. Lace, MSE, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 202 Commercial Ave E, Wynne, AR 72396 Phone: 870-238-4329 Fax: 870-208-8935
David M Ray, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1792 Falls Blvd N, Ste. 5, Wynne, AR 72396 Phone: 870-208-9333 Fax: 870-208-9229
Tabatha Bradley, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 204 Mississippi St S, Wynne, AR 72396 Phone: 870-208-8499
Kayla Baker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 Bridges Ave E, Wynne, AR 72396 Phone: 870-336-1300
Amanda Turnbow, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1792 Falls Blvd N, Wynne, AR 72396 Phone: 870-208-9333
Mr. Michael S. Miller, LPC Counselor Medicare: Medicare Enrolled Practice Location: 204 Mississippi St S, Wynne, AR 72396 Phone: 870-208-8499

Katelyn Boles, LPC - Medicare Counselor in Wynne, AR