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NPI Code Detail

MEDICARE: TAYLOR BOESE COUNSELING LLC

MEDICARE: TAYLOR BOESE COUNSELING LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1003786690
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAYLOR BOESE COUNSELING LLC
Provider Business Mailing Address
First Line : 11816 SW 2ND ST
Second Line :
City : YUKON
State : OK
Zip : 73099-7112
Country : US
Telephone Number : 580-210-8427
Fax Number :
Provider Business Practice Location Address
First Line : 5100 N BROOKLINE AVE STE 325
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-3609
Country : US
Telephone Number : 405-265-9259
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TAYLOR BOESE
Credential : MS, LPC
Telephone Number : 580-210-8427
Provider Enumeration Date : 11/07/2025
Last Update Date : 11/07/2025

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Directions to “TAYLOR BOESE COUNSELING LLC ” Practice Location

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