MEDICARE: MICHELLE N BOLTON-LAWSON CDCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1518818517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE N BOLTON-LAWSON CDCA

Provider Business Mailing Address
First Line	:	6141 SANDBURY DR
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-3748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 E 3RD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1850
Country	:	US
Telephone Number	:	937-310-1269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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