Kathi Boren, | |
514 S Main St, Perryton, TX 79070-3152 | |
(806) 202-8681 | |
Not Available |
Full Name | Kathi Boren |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 514 S Main St, Perryton, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609258391 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2763 (Kansas) | Secondary |
101YP2500X | Counselor - Professional | 0013651 (Colorado) | Primary |
Entity Name | Tri-state Area Behavioral Health, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407561541 PECOS PAC ID: 8628421963 Enrollment ID: O20240202000258 |
Mailing Address | Practice Location Address |
---|---|
Kathi Boren, 1305 S Harvard St, Perryton, TX 79070-4412 Ph: (806) 202-8681 | Kathi Boren, 514 S Main St, Perryton, TX 79070-3152 Ph: (806) 202-8681 |
Mrs. Candace Dawn Lizardo, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1613 S. Colgate, Perryton, TX 79070 Phone: 806-228-6226 Fax: 806-434-2715 | |
Randi Michelle Cunningham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 215 S Kentucky St, Perryton, TX 79070 Phone: 806-202-7073 | |
Cynthia M Smith, M.S., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1613 S Colgate St, Perryton, TX 79070 Phone: 806-434-0332 Fax: 806-434-2715 |