Jacqueline M Boles, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

202770 Issued in TX

Practice address

1603 Medical Pkwy Ste 320
Cedar Park, TX 78613-7904

Phone

(512) 765-6788

NPI assigned

Dec 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1942539838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL PKWY STE 320",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137904",
            "telephone_number": "512-765-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL PKWY STE 320",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137904",
            "telephone_number": "512-765-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "202770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "1942539838",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Boeck, M.D.
• Michael Bruce Bogdanovich, MD
• Nathanael Bogedain, D.C. M.SC
• Lindsay Bogenn
• Carrie Jean Bolen, OD
• Edward J Bombach, MD
• Caroline Mary Bonnema, MSN, APRN, AGNP-C
• Madison Bonsall, BCBA
• Kimberly Borchert, CD
• Robert Borromeo, PT, DPT

• Marriage & Family Therapist in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.