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General NPI Number Information
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NPI Number | 1821730359
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Entity Type | Organization
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Legal Business Name | MINDFUL POSSIBILITIES LLC ROBERT COREY BOES SOLE MBR
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 905 W CANTEY ST
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City | FORT WORTH
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State | TX
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Zip | 76110-3205
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Country | US
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Telephone | 817-382-1876
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Fax |
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Provider Business Mailing Address
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Address Line | 905 W CANTEY ST
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City | FORT WORTH
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State | TX
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Zip | 76110-3205
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Country | US
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Telephone | 817-382-1876
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ROBERT COREY BOES
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Credential | LCSW-S
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Telephone | 817-382-1876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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