Active NPI
Thomas Edgerton Boles, LPC
- Professional Counselor
- Durham, NC
National Provider Identifier
1619009206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5068
- Practice address
- 219 S Mangum St
Durham, NC 27701-3618 - Phone
- (919) 560-0975
- NPI assigned
- Mar 10, 2007
- Sex
- Male
- 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 | 5068 | NC | Primary |
Addresses
Primary practice location
219 S Mangum St
Durham, NC 27701-3618
Mailing address
219 S Mangum St
731 Millspring Drive
Durham, NC 27701-3618
Phone (919) 560-0975
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619009206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 S MANGUM ST",
"address_2": "731 MILLSPRING DRIVE",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013618",
"telephone_number": "919-560-0975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 S MANGUM ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013618",
"telephone_number": "919-560-0975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLES",
"first_name": "THOMAS",
"middle_name": "EDGERTON",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "5068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.