1. Home
  2. Directory
  3. Georgia
  4. Brunswick
  5. Counselor
  6. NPI Profile

KENDALL DISA BOGES LPC
NPI 1013634179
Counselor - Professional in Brunswick, GA

Active since October 20, 2022PECOS Enrolled
1600 ELLIS ST, BRUNSWICK, GA 31520(912) 289-1626(912) 289-2414 Get Directions Write a Review

NPPES record last updated: October 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kendall Disa Boges Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDALL DISA BOGES LPC (NPI 1013634179) is an individual professional provider in Brunswick, Georgia, licensed in Georgia (LPC011466) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013634179
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKENDALL DISA BOGESCredential: LPC
Location Address1600 ELLIS STBrunswick, GA 31520-6737
Mailing Address191 Drew CirBrunswick, GA 31525-1049 · (912) 580-6578
Phone(912) 289-1626
Fax(912) 289-2414
Sole ProprietorNo
Enumeration DateOctober 20, 2022
NPPES CertifiedSeptember 9, 2022
✔ NPI 1013634179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC011466
1600 ELLIS ST, Brunswick, GA 31520
Open in Google Maps ↗

Other Names 1

Professional Name (2)Kendall Disa Benton Lpc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kendall Disa Boges Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COASTAL COMMUNITY HEALTH SERVICES, INC.
Pharmacy (Community/Retail Pharmacy)
1600 ELLIS ST
BRUNSWICK, GA 31520
Glynn County (912) 574-5279
NICHOLE L MUCHISON FNP-BC
Nurse Practitioner (Family)
1600 ELLIS ST
BRUNSWICK, GA 31520
Glynn County (912) 289-2006
MANOUCHKA L ETIENNE PA-C
Physician Assistant (Medical)
1600 ELLIS ST
BRUNSWICK, GA 31520
Glynn County (912) 289-2006
COASTAL COMMUNITY HEALTH SERVICES INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1600 ELLIS ST
BRUNSWICK, GA 31520
Glynn County (912) 289-2006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendall Boges's NPI number?

The NPI number for Kendall Boges is 1013634179. It was assigned to this individual provider in the NPPES registry on October 20, 2022. The provider is also known as Kendall Disa Benton Lpc.

Where is Kendall Boges located?

Kendall Boges practices at 1600 Ellis St, Brunswick, GA 31520. The listed phone number is (912) 289-1626.

What is Kendall Boges's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kendall Boges enrolled in Medicare?

Yes. Kendall Boges is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kendall Boges was last updated on October 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.