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General NPI Number Information
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NPI Number | 1598311680
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Entity Type | Organization
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Legal Business Name | BOLGER PSYCHOTHERAPY & ASSESSMENTS, LLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 191 SOWAMS RD
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City | BARRINGTON
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State | RI
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Zip | 02806-4607
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Country | US
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Telephone | 401-218-8630
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Fax | 401-441-6529
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Provider Business Mailing Address
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Address Line | 191 SOWAMS RD
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City | BARRINGTON
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State | RI
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Zip | 02806-4607
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Country | US
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Telephone | 401-218-8630
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Fax | 401-441-6529
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Authorized Official
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Title or Position | MEMBER OF LLC
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Name | CHANTAL BOLGER
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Credential | LMHC
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Telephone | 401-218-8630
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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 |
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License Number State |
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