Katie Leann Bolen, B.S., QMHS, SWT
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Moraine, OH
NPI 1063265122 · NPPES record last updated Jul 26, 2026
Key facts
- NPI
- 1063265122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2211 Arbor Blvd
Moraine, OH 45439-1521 - Phone
- (937) 222-9481
- NPI assigned
- Apr 9, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Service Association | Past |
Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/fsadayton/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2211 Arbor Blvd
Moraine, OH 45439-1521
Mailing address
2211 Arbor Blvd
Moraine, OH 45439-1521
Phone (937) 222-9481
Other providers in Moraine, OH
- Ciara Nicole Blake
- Michael Kent Blosser
- Keymariah Boatman
- Jonathon Boehringer
- Josephine Boland
- Michelle Nicole Bonnet
- Kyla Booher
- Belinda Renee Boomershine
- Boston Brace International Inc
- Daniel Todd Bourne
All providers in Moraine, OH · Student in an Organized Health Care Education/Training Program in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.