Tracyann Marie Spaulding Bolstridge, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

002277 Issued in CT

Practice address

58 Missionary Rd
Cromwell, CT 06416-2134

Phone

(860) 635-6010

NPI assigned

Aug 26, 2013

Last updated

Aug 26, 2013By 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

Medicare fee-for-service enrollment

Enrolled in CT

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

State licenses

Practice roles

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

• Adelbrook Community Services, Inc.

  • Community/Behavioral Health Agency
  • Cromwell, CT
  • NPI 1134275647
  NPD (past)
• The Children's Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Cromwell, CT
  • NPI 1710216163
  NPD (past)

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1043644123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 MISSIONARY RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162134",
            "telephone_number": "860-635-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 MISSIONARY RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162134",
            "telephone_number": "860-635-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING BOLSTRIDGE",
        "first_name": "TRACYANN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "002277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Leigh Smith
• Matthew Joseph Smith
• Rebecca Erin Snyder
• Michael Stephen Soehnlen, O.D
• Cheryl Ann Soucy, OTD
• Specialized Behavioral Care LLC
• Erica Splain
• Stanley E. Schulman, D.M.D., LLC
• Devin Stanley
• Valerie Stanton

• Mental Health Counselor in Cromwell, CT
• Providers in Cromwell, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.