Active NPI
Brittney R Bolden, M.S.
- Marriage & Family Therapist
- Evanston, IL
National Provider Identifier
1023377371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0921-14-5878
- Practice address
- 618 Library PL
Evanston, IL 60201-2908 - Phone
- (847) 733-4300
- NPI assigned
- May 7, 2012
- Last updated
- May 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 0921-14-5878 | IN | Primary |
Addresses
Primary practice location
618 Library PL
Evanston, IL 60201-2908
Mailing address
7512 N Eastlake Ter Apt 1W
Chicago, IL 60626-1456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336348800000",
"number": "1023377371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7512 N EASTLAKE TER APT 1W",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606261456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 LIBRARY PL",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602012908",
"telephone_number": "847-733-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "BRITTNEY",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-07",
"last_updated": "2012-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "0921-14-5878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.