Individual provider · Type 1 NPI

Roger Boleyn, CASE MANAGER

Mental Health Counselor · Jackson, TN

NPI number 1295857753 Active

Practice location

238 Summar Dr
Jackson, TN 38301-3906

Mailing address

1804 Highway 45 Byp, Suite 604
Jackson, TN 38305-4436

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1295857753

Roger Boleyn, CASE MANAGER's National Provider Identifier is 1295857753, issued on Apr 4, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jackson, TN. The record was last updated on Aug 6, 2009.