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NPI Code Detail

MEDICARE: HEATHER BOISE LMHC

MEDICARE: HEATHER BOISE LMHC
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
1101YM0800XMental Health Counselor8000969AIN

General Provider Information

NPI Number : 1972171510
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER BOISE LMHC
Provider Business Mailing Address
First Line : 138 CAPITOL DR APT A
Second Line :
City : AVON
State : IN
Zip : 46123-4541
Country : US
Telephone Number : 219-869-4196
Fax Number :
Provider Business Practice Location Address
First Line : 4695 E NORTHFIELD DR
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-1784
Country : US
Telephone Number : 317-520-4748
Fax Number : 888-498-5529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2021
Last Update Date : 11/30/2023

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