Samuel K Bore, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

62432 Issued in TX

Practice address

4683 Betts Dr
Grand Prairie, TX 75052-1801

Phone

(469) 835-2904

NPI assigned

Aug 28, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1457909905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 BROOKHAVEN DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523587",
            "telephone_number": "469-835-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4683 BETTS DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521801",
            "telephone_number": "469-835-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORE",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "62432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precious Laquon Bolden
• Latuavia Bonner
• Darla R. Booker, M.A.
• David L Booker, PTA
• Michael Booth, MD
• Maya Miko Botomani-Mposi, PA-C
• Zachary Q. Botone, MD
• Keana Bradley, LPC
• Patrick R Brady, D.D.S., M.S.
• Sharlene Brady

• Mental Health Counselor in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.