Immaculate Mbolle

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

6911 Laurel Bowie Rd Ste 309
Bowie, MD 20715-1712

Phone

(301) 755-4021

NPI assigned

Jun 16, 2025

Last updated

Jun 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Immaculate Mbolle Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1013803253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11404 STEWART LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042216",
            "telephone_number": "301-442-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 LAUREL BOWIE RD STE 309",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151712",
            "telephone_number": "301-755-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOLLE",
        "first_name": "IMMACULATE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IMMACULATE",
            "last_name": "MBOLLE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Frankline a Mbekem Anyi Sr.
• Bonaventure Mbella
• Marian Nso Mbi, NP
• Leslie Verberi Mbiydzenyuy
• Adeline Mbokeh
• Cecilia Tanu Mbongmbowo, CNA
• Stella Nahbila Mbotiji
• Elizabeth Mbou
• Gisele Asongtia Mbuababi
• Hannah W Mbugu

• Behavior Technician in Bowie, MD
• Providers in Bowie, MD by specialty
• Behavior Technician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.