Active NPI
Marissa Linn Boles, TLMHC
- Mental Health Counselor
- West Branch, IA
National Provider Identifier
1811756752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 124599
- Practice address
- 233 S 2ND St
West Branch, IA 52358-9620 - Phone
- (319) 643-2532
- Fax
- (319) 643-5708
- NPI assigned
- Mar 14, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 124599 | IA | Primary |
Addresses
Primary practice location
233 S 2ND St
West Branch, IA 52358-9620
Mailing address
PO Box 130
West Branch, IA 52358-0130
Phone (319) 643-2532
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 |
|---|---|---|---|
| 124599 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1811756752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"city": "WEST BRANCH",
"state": "IA",
"postal_code": "523580130",
"telephone_number": "319-643-2532",
"fax_number": "319-643-5708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 S 2ND ST",
"city": "WEST BRANCH",
"state": "IA",
"postal_code": "523589620",
"telephone_number": "319-643-2532",
"fax_number": "319-643-5708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLES",
"first_name": "MARISSA",
"middle_name": "LINN",
"credential": "TLMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-14",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "124599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Branch, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.