DR. KWONEATHIA BOSWELL (PH.D.) – Psychologist, NPI 1447961784

DR. KWONEATHIA BOSWELL (PH.D.) is a healthcare provider. based in Montgomery, Alabama. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. The NPI Number for DR. KWONEATHIA BOSWELL (PH.D.) is 1447961784

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. KWONEATHIA BOSWELL (PH.D.)
NPI
1447961784
Phone
Not provided
Address
3030 IVY CHASE LOOP
Enumeration Date
7 December 2022
Last Update Date
9 December 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
3342627787
Graduation Year
2016 (10 years ago)
PAC ID
8426405739
Group Practice PAC ID
7113922063
Professional Enrollment ID
I20231108001622
Address ID
AL361062648MO2911XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:3State licenses:0Digital endpointsOther names

160 CLINICAL PSYCHOLOGIST in AL

Provider Addresses for DR. KWONEATHIA BOSWELL (PH.D.)

  • 3030 IVY CHASE LOOP

    MONTGOMERY, AL 361176983

    Phone:

    Type: Mailing

  • 2911 ZELDA RD

    MONTGOMERY, AL 361062648

    Phone: (334) 262-7787

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231108001622IPsychologist Billing IndependentlyALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36117)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113922063View full group profile
NameSpecialtyState
Mental Health CounselorAL
Mental Health CounselorAL
Clinical PsychologistAL

Reviews

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Frequently asked questions

Can I cross-check DR. KWONEATHIA BOSWELL (PH.D.) using NPI 1447961784?
NPI 1447961784 belongs to DR. KWONEATHIA BOSWELL (PH.D.); compare other details if you need extra assurance.
Would DR. KWONEATHIA BOSWELL (PH.D.) appear as active to a payer?
You can treat DR. KWONEATHIA BOSWELL (PH.D.) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DR. KWONEATHIA BOSWELL (PH.D.)'s focus?
For DR. KWONEATHIA BOSWELL (PH.D.), the primary taxonomy reads as Psychologist. Clinical services aligned with this taxonomy classification.
Is DR. KWONEATHIA BOSWELL (PH.D.) associated with Montgomery?
Public fields place DR. KWONEATHIA BOSWELL (PH.D.) around Montgomery, Alabama. Always confirm the exact site before visiting.
Does DR. KWONEATHIA BOSWELL (PH.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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Unknown Individual

Psychologist
4216, Lomac Street, Brookwood Estates, Montgomery, Montgomery County, Alabama, 36106, United States
NPI: 1275680027