NPIMap

Organization Active NPI

Mindful Possibilities LLC Robert Corey Boes Sole MBR

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Worth, TX
National Provider Identifier
1821730359
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MINDFUL POSSIBILITIES LLC ROBERT COREY BOES SOLE MBR
Practice address
905 W Cantey St
Fort Worth, TX 76110-3205
Phone
(817) 382-1876
NPI assigned
Apr 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Robert Corey Boes, LCSW-SNPI 1558827949
Title
Founder
Phone
(817) 382-1876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

905 W Cantey St
Fort Worth, TX 76110-3205

Mailing address

905 W Cantey St
Fort Worth, TX 76110-3205
Phone (817) 382-1876

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert@mindfulpossibilities.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230209000206 TX Part B Supplier - Clinic/Group Practice 9638541196 Receives reassigned benefits from 5 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

610 S Jennings Ave
Ste C
Fort Worth, TX 76104
Phone (817) 352-1876

905 W Cantey St
Ft Worth, TX 76110
Phone (817) 382-1876

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1821730359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W CANTEY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761103205",
            "telephone_number": "817-382-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W CANTEY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761103205",
            "telephone_number": "817-382-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL POSSIBILITIES LLC ROBERT COREY BOES SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "BOES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "COREY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "817-382-1876",
        "authorized_official_credential": "LCSW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert@mindfulpossibilities.org",
            "affiliation": "N",
            "address_1": "905 W Cantey St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761103205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.