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General NPI Number Information
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NPI Number | 1467798744
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Entity Type | Individual
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Provider Name | JOSEPH BOLDUC LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 5959 COLLINS AVE APT. 1403
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2289
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Country | US
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Telephone | 305-209-4561
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Fax |
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Provider Business Mailing Address
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Address Line | 52R POINT ST
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City | PROVINCETOWN
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State | MA
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Zip | 02657-1915
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Country | US
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Telephone | 203-962-1710
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH11465
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 005803-1
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License Number State | NY
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