Brian Keith Boles, WYOMING LPC 1705

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1705 Issued in WY

Practice address

1430 Wilkins Cir
Casper, WY 82601-1336

Phone

(307) 237-9583

Fax

(307) 265-7277

NPI assigned

Sep 24, 2015

Last updated

Jan 5, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Joseph Yeretsian PCGroup PAC ID 5597893313, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Joseph Yeretsian, P.C.

  dba OptiMindHealth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boulder, CO
  • NPI 1942668165
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1912376575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 WILKINS CIR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826011336",
            "telephone_number": "307-237-9583",
            "fax_number": "307-265-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 WILKINS CIR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826011336",
            "telephone_number": "307-237-9583",
            "fax_number": "307-265-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "WYOMING LPC 1705",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "1705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Remie Blythe, DO
• Jaime Rose Bobinmyer-Hornecker, PHARM.D.
• Body N Motion
• Karl Edward Boehm, DO
• Bokbh LLC
• Jeneil Boles
• Mary C Boltz, RN
• Anna Jean Bond, RN
• Daniel Ryan Bonifield, D.O.
• Angela Lee Booth, APRN

• Professional Counselor in Casper, WY
• Providers in Casper, WY by specialty
• Professional Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.