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NPI Code Detail

MEDICARE: BOOST YOUR LIFE COUNSELING AND CONSULTING, LLC

MEDICARE: BOOST YOUR LIFE COUNSELING AND CONSULTING, 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 : 1578309399
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOOST YOUR LIFE COUNSELING AND CONSULTING, LLC
Provider Business Mailing Address
First Line : 5555 WHITTLESEY BLVD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-7212
Country : US
Telephone Number : 706-392-5603
Fax Number :
Provider Business Practice Location Address
First Line : 5555 WHITTLESEY BLVD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-7212
Country : US
Telephone Number : 706-392-5603
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : MR. ROBY K MURPHY
Credential : LPC
Telephone Number : 706-392-5603
Provider Enumeration Date : 07/02/2024
Last Update Date : 07/02/2024

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Directions to “BOOST YOUR LIFE COUNSELING AND CONSULTING, LLC ” Practice Location

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