Katelyn Boles, LPC | |
1825 E Broadway St, Forrest City, AR 72335-3409 | |
(870) 630-2328 | |
(870) 630-2348 |
Full Name | Katelyn Boles |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 1825 E Broadway St, Forrest City, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265980593 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | P1904050 (Arkansas) | Primary |
101YM0800X | Counselor - Mental Health | A1609114 (Arkansas) | Secondary |
Entity Name | Changes Behavioral Health, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114260486 PECOS PAC ID: 6103149653 Enrollment ID: O20150108001118 |
Mailing Address | Practice Location Address |
---|---|
Katelyn Boles, LPC 204 Mississippi St S, Wynne, AR 72396-3025 Ph: (870) 208-8499 | Katelyn Boles, LPC 1825 E Broadway St, Forrest City, AR 72335-3409 Ph: (870) 630-2328 |
Donnie Jackson, RN Counselor Medicare: Not Enrolled in Medicare Practice Location: 1825 E Broadway St, Forrest City, AR 72335 Phone: 870-630-2328 Fax: 870-630-2348 | |
Jordan Wilkison, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1521 N Washington St, Forrest City, AR 72335 Phone: 870-633-8092 Fax: 870-633-8358 | |
Mary Linn, RN Counselor Medicare: Not Enrolled in Medicare Practice Location: 1825 E Broadway St, Forrest City, AR 72335 Phone: 870-630-2328 Fax: 870-630-2348 | |
Dawn Herring, THERAPIST Counselor Medicare: Not Enrolled in Medicare Practice Location: 1825 E Broadway St, Forrest City, AR 72335 Phone: 870-630-2328 Fax: 870-630-2348 | |
Sheila J. Lowery, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1825 E Broadway St, Forrest City, AR 72335 Phone: 870-630-2328 | |
Marsha Goff, RN Counselor Medicare: Not Enrolled in Medicare Practice Location: 1825 E Broadway St, Forrest City, AR 72335 Phone: 870-630-2328 Fax: 870-630-2348 | |
Charmane Alvares, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1800 Lindauer Rd, Forrest City, AR 72335 Phone: 870-494-4600 |