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General NPI Number Information
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NPI Number | 1194897140
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Entity Type | Individual
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Provider Name | BARBARA BOSS MARTIN LPC LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5422 CLINTON BLVD
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City | JACKSON
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State | MS
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Zip | 39209
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Country | US
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Telephone | 601-923-1635
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Fax | 601-923-1634
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Provider Business Mailing Address
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Address Line | 120 KEITH LANE
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City | CLINTON
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State | MS
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Zip | 39056
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Country | US
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Telephone | 601-924-2041
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Fax | 601-923-1634
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0618
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0192
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License Number State | MS
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