MEDICARE: ROBYN ANN BOLES LCSW

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
1	1041C0700X	Clinical Social Worker	61641	TX

General Provider Information

NPI Number	:	1205314705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN ANN BOLES LCSW

Provider Business Mailing Address
First Line	:	3740 FARM ROAD 1735
Second Line	:
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75455-0928
Country	:	US
Telephone Number	:	903-374-8040
Fax Number	:	903-213-9175

Provider Business Practice Location Address
First Line	:	3740 FARM ROAD 1735
Second Line	:
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75455-0928
Country	:	US
Telephone Number	:	903-374-8040
Fax Number	:	903-205-1779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2018
Last Update Date	:	02/16/2026

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Directions to “ ROBYN ANN BOLES LCSW” Practice Location

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