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NPI Code Detail

MEDICARE: KENYA M BOSON M.ED., LPC

MEDICARE: KENYA M BOSON M.ED., LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor67084TX
2101YM0800XMental Health Counselor67084TX
3101YS0200XSchool Counselor67084TX
4101YP2500XProfessional Counselor67084TX

General Provider Information

NPI Number : 1497179949
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENYA M BOSON M.ED., LPC
Provider Business Mailing Address
First Line : PO BOX 80233
Second Line :
City : AUSTIN
State : TX
Zip : 78708-0233
Country : US
Telephone Number : 512-318-2503
Fax Number :
Provider Business Practice Location Address
First Line : 7600 CHEVY CHASE DR STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78752-1599
Country : US
Telephone Number : 512-318-2503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2014
Last Update Date : 03/20/2025

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