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NPI Code Detail

MEDICARE: TERESA Y BOLT LPCC-S

MEDICARE: TERESA Y BOLT LPCC-S
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
1101YP2500XProfessional CounselorE.0900362SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881999647
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA Y BOLT LPCC-S
Provider Business Mailing Address
First Line : 80 SUNBURY RD
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-3062
Country : US
Telephone Number : 740-637-9768
Fax Number :
Provider Business Practice Location Address
First Line : 5982 RHODES RD
Second Line :
City : KENT
State : OH
Zip : 44240-8100
Country : US
Telephone Number : 330-676-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2011
Last Update Date : 11/15/2024

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Directions to “ TERESA Y BOLT LPCC-S” Practice Location

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