Denise Ann Boldt

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

7678 Cottonwood Dr Ste C
Jenison, MI 49428-7312

Phone

(616) 426-9034

NPI assigned

Dec 21, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rebuild and Restore Counceling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hudsonville, MI
  • NPI 1588599740
  NPD Authorized official
• Second Story Counseling II LLC

  • Counselor
  • Hudsonville, MI
  • NPI 1013460716
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1013452465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3872 SUNDIAL AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268423",
            "telephone_number": "616-896-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7678 COTTONWOOD DR STE C",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287312",
            "telephone_number": "616-426-9034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3872 Sundial Ave",
            "address_purpose": "LOCATION",
            "city": "Hudsonville",
            "state": "MI",
            "postal_code": "494268423",
            "country_code": "US",
            "telephone_number": "616-896-7550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDT",
        "first_name": "DENISE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracie Bernardine
• Madison Beversluis
• Jeremy Bissett
• Bluestone Care, LLC
• Nancy Boersen, RN
• Terry Joe Bonebrake, CARE MANAGER/QIDP
• Elisabeth Leigh Boot, M.A. CCC-SLP
• Douglas Paul Borst, DDS
• Matthew Paul Borst, DDS.
• Joel Bradley

• Professional Counselor in Jenison, MI
• Providers in Jenison, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.