Healthcare Provider Details
I. General information
NPI: 1750637757
Provider Name (Legal Business Name): BOLTON COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2012
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
745 S CHURCH ST STE 805
MURFREESBORO TN
37130-4983
US
IV. Provider business mailing address
745 S CHURCH ST STE 805
MURFREESBORO TN
37130-4983
US
V. Phone/Fax
- Phone: 615-624-4481
- Fax:
- Phone: 615-624-4481
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
LEE
BOLTON
Title or Position: OWNER
Credential: LPC-MHSP, MT-BC
Phone: 615-624-4481