Terise Robin Boggs, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79613 Issued in TX

Practice address

3613 Williams Dr Ste 302
Georgetown, TX 78628-1369

Phone

(512) 317-9763

NPI assigned

Dec 26, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1640476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1023778586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 302",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281369",
            "telephone_number": "512-942-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 WILLIAMS DR STE 302",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281369",
            "telephone_number": "512-317-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "TERISE",
        "middle_name": "ROBIN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-26",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "terise@impactcounselingservices.org",
            "affiliation": "Y",
            "endpointDescription": "business email",
            "affiliationName": "Impact Counseling Services, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3613 Williams Dr Ste 302",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786281369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bluebird Medical Enterprises
• Bluebonnet Vision Associates
• Anuoluwapo Temitope Bode-Oloye
• Natasha Lee Bogacz
• Tania Bogan Phillips
• Ann Bogus, LPC
• Thomas Charles Bohmfalk, MD
• Barbara Myers Bolding, M.ED.
• Melissa Boliek
• Cody Scott Boling, LAT

• Professional Counselor in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.