Bruce J. Boswell, Lpc, Pc | |
4925 Everhart Rd Ste 103 Corpus Christi TX 78411-3912 | |
(361) 806-2600 | |
(361) 806-2624 |
Full Name | Bruce J. Boswell, Lpc, Pc |
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Speciality | Counselor |
Location | 4925 Everhart Rd Ste 103, Corpus Christi, Texas |
Authorized Official Name and Position | Bruce J Boswell (OWNER) |
Authorized Official Contact | 3618062600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bruce J. Boswell, Lpc, Pc Po Box 271416 Corpus Christi TX 78427-1416 Ph: (361) 806-2600 | Bruce J. Boswell, Lpc, Pc 4925 Everhart Rd Ste 103 Corpus Christi TX 78411-3912 Ph: (361) 806-2600 |
NPI Number | 1851953590 |
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Provider Enumeration Date | 07/02/2019 |
Last Update Date | 11/14/2023 |
Certification Date | 11/14/2023 |
Medicare PECOS PAC ID | 0042653404 |
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Medicare Enrollment ID | O20240213002145 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851953590 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Bruce J Boswell |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1255416574 PECOS PAC ID: 9638392657 Enrollment ID: I20240215002063 |
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