Provider Demographics
NPI:1205314705
Name:BOLES, ROBYN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:ANN
Last Name:BOLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:ANN
Other - Last Name:MORGAN BOLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3740 FARM ROAD 1735
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-0928
Mailing Address - Country:US
Mailing Address - Phone:903-374-8040
Mailing Address - Fax:903-205-1779
Practice Address - Street 1:3740 FARM ROAD 1735
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-0928
Practice Address - Country:US
Practice Address - Phone:903-374-8040
Practice Address - Fax:903-205-1779
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX616411041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical