MR. BRIAN KEITH BOLES (WYOMING LPC 1705) – Professional Counselor, NPI 1912376575

MR. BRIAN KEITH BOLES (WYOMING LPC 1705) is a healthcare provider. based in Casper, Wyoming. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials WYOMING LPC 1705. They hold a License No. 1705 (WY). The NPI Number for MR. BRIAN KEITH BOLES (WYOMING LPC 1705) is 1912376575

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRIAN KEITH BOLES (WYOMING LPC 1705)
NPI
1912376575
Phone
(307) 237-9583
Address
1430 WILKINS CIR
Enumeration Date
24 September 2015
Last Update Date
5 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7207984516
Graduation Year
2014 (12 years ago)
PAC ID
3274073143
Group Practice PAC ID
5597893313
Professional Enrollment ID
I20240905003763
Address ID
CO803032669BO4770XRDXX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

271 MENTAL HEALTH COUNSELOR in WY

Provider Addresses for MR. BRIAN KEITH BOLES (WYOMING LPC 1705)

  • 1430 WILKINS CIR

    CASPER, WY 826011336

    Phone: (307) 237-9583

    Fax: (307) 265-7277

    Mailing address matches the actual address.

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: 2024-09-05

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
I20240905003763IMental Health CounselorCOTBD

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 82601)

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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: 5597893313View full group profile
NameSpecialtyState
Nurse PractitionerCO
Mental Health CounselorGA
Nurse PractitionerCO
Nurse PractitionerCO
Nurse PractitionerMA
Nurse PractitionerCO
Marriage And Family TherapistFL
Mental Health CounselorTX
Nurse PractitionerGA
Nurse PractitionerOH

Reviews

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Frequently asked questions

Where can patients find MR. BRIAN KEITH BOLES (WYOMING LPC 1705)'s NPI?
You can confirm MR. BRIAN KEITH BOLES (WYOMING LPC 1705) with NPI 1912376575; it appears in the national provider directory.
Is MR. BRIAN KEITH BOLES (WYOMING LPC 1705) active in the national directory?
MR. BRIAN KEITH BOLES (WYOMING LPC 1705)'s public NPI profile is in an active state.
What field does MR. BRIAN KEITH BOLES (WYOMING LPC 1705) work in?
You can think of MR. BRIAN KEITH BOLES (WYOMING LPC 1705) as practicing within Professional Counselor. Clinical services aligned with this taxonomy classification.
Where is MR. BRIAN KEITH BOLES (WYOMING LPC 1705)'s primary listing?
We display Casper, Wyoming because that is what the record indicates for MR. BRIAN KEITH BOLES (WYOMING LPC 1705).
Is MR. BRIAN KEITH BOLES (WYOMING LPC 1705) a real provider?
This page reflects official NPPES data for NPI 1912376575. Always confirm identity and privileges with the practice and licensing boards.

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