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General NPI Number Information
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NPI Number | 1184570293
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Entity Type | Organization
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Legal Business Name | JESSICA BOLDEN PSYCHOTHERAPY GROUP, PLLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 213 OLD ANNETTA RD
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City | ALEDO
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State | TX
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Zip | 76008-4455
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Country | US
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Telephone | 817-887-8157
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Fax |
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Provider Business Mailing Address
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Address Line | 149 ELLIS SPRING DR
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City | WEATHERFORD
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State | TX
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Zip | 76085-1634
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Country | US
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Telephone | 432-664-2261
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA RENEE RILEY-BOLDEN
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Credential | MA, LPC-S
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Telephone | 432-664-2261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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