Individual provider Active NPI

Bruce Boswell, LPC

  • Counselor
  • Corpus Christi, TX
National Provider Identifier
1255416574
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
17545 Issued in TX
Practice address
4925 Everhart Rd Ste 103
Corpus Christi, TX 78411
Phone
(361) 806-2600
Fax
(361) 806-2624
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 17545 TX
Counselor 101Y00000X 17545 TX Primary

Addresses

Primary practice location

4925 Everhart Rd Ste 103
Corpus Christi, TX 78411

Mailing address

PO Box 271416
Corpus Christi, TX 78427-1416
Phone (361) 334-1136

Other identifiers 2

IdentifierTypeStateIssuer
1509028-02MedicaidTX
150902801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215002063 TX Practitioner - Mental Health Counselor 9638392657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4925 Everhart Rd
Suite 103
Corpus Christi, TX 78411-3912
Phone (361) 806-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce J. Boswell, LPC, PC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

4925 Everhart Rd
Ste 103
Corpus Christi, TX 78411
Phone (361) 806-2600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1255416574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271416",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784271416",
            "telephone_number": "361-334-1136",
            "fax_number": "361-334-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 EVERHART RD STE 103",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78411",
            "telephone_number": "361-806-2600",
            "fax_number": "361-806-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "17545",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "17545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509028-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150902801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.