Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tanner Lee Boles, MA

Individual provider Mental Health Counselor · NPI 1104247279

Tanner Lee Boles, MA is a Mental Health Counselor in Moore, Oklahoma. Qualified in 2017, 9 years ago. Practices as a sole proprietor. Licensed in Oklahoma.

Years since qualifying
9
Licensed in
OK
In the registry since
2013
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

620 NW 5th St
Moore, OK 73160-3948
Phone: (405) 208-4469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LPC06783 (OK)

Record details

NPI number1104247279
Entity typeIndividual (Type 1)
GenderMale
Credentials MA
Sole proprietorYes
NPI enumeratedDecember 17, 2013
Last updated in NPPESOctober 25, 2023
Certification dateOctober 25, 2023
Mailing address9124 Rolling Meadows Dr, Guthrie, OK 73044-8645

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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