Healthcare Provider Details

I. General information

NPI: 1881598787
Provider Name (Legal Business Name): BRITTNEY KAY BOLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4118 WILLIAMS DR
GEORGETOWN TX
78628-1335
US

IV. Provider business mailing address

546 WESTBURY LN
GEORGETOWN TX
78633-4465
US

V. Phone/Fax

Practice location:
  • Phone: 512-651-1009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103719
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: