Laura Thorne Boles, MDIV, BCC

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

484 Summit Ave
Mill Valley, CA 94941-4518

Phone

(415) 672-0307

NPI assigned

Apr 5, 2023

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 5, 2023.

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1093400293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 SUMMIT AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949414518",
            "telephone_number": "415-672-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 SUMMIT AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949414518",
            "telephone_number": "415-672-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "LAURA",
        "middle_name": "THORNE",
        "credential": "MDIV, BCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey H Binstock, MD
• Whitney Jacqueline Bird, L.AC, DACM
• Matthew David Blagys, PH. D.
• Stephen Howard Blose, VMD
• Jean Shinoda Bolen, M.D.
• Nichole Dinell Bond
• Carter Bostwick, AMFT
• Derek Lane Boudreaux, D.C.
• Aaron Bowe, PT, DPT
• Roberta Heath Bradshaw, MA, LMFT

• All providers in Mill Valley, CA
• Pastoral Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.