Issac Luther Boose Jr., LPC, LMFT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

883 Issued in MS

Practice address

57 Griffin Rd
Richton, MS 39476-9224

Phone

(601) 408-8828

NPI assigned

Jan 3, 2021

Last updated

Jan 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Issac Luther Boose Jr. Professional name

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": "1609632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609632000000",
    "number": "1992393318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 GRIFFIN RD",
            "city": "RICHTON",
            "state": "MS",
            "postal_code": "394769224",
            "telephone_number": "601-408-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GRIFFIN RD",
            "city": "RICHTON",
            "state": "MS",
            "postal_code": "394769224",
            "telephone_number": "601-408-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOSE",
        "first_name": "ISSAC",
        "middle_name": "LUTHER",
        "name_suffix": "Jr.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-03",
        "last_updated": "2021-01-03",
        "certification_date": "2021-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISSAC",
            "last_name": "BOOSE",
            "middle_name": "LUTHER",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "ISSAC L. BOOSE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Counselor in Richton, MS
• Providers in Richton, MS by specialty
• Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2021; 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.