Active NPI
Susan E Boles, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1265752513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63416
- Practice address
- 9817 Crawford Farms Dr
Fort Worth, TX 76244-6601 - Phone
- (817) 723-9780
- NPI assigned
- Jun 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63416 | TX | Primary |
Addresses
Primary practice location
9817 Crawford Farms Dr
Fort Worth, TX 76244-6601
Mailing address
9817 Crawford Farms Dr
Fort Worth, TX 76244-6601
Phone (817) 723-9780
Other names 1
- Susan E Stone
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63416 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276041600000",
"number": "1265752513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9817 CRAWFORD FARMS DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762446601",
"telephone_number": "817-723-9780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9817 CRAWFORD FARMS DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762446601",
"telephone_number": "817-723-9780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLES",
"first_name": "SUSAN",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2010-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "STONE",
"middle_name": "E",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.