Active NPI
Angela M Bolenbaugh, MS, LPC
- Professional Counselor
- Orient, OH
National Provider Identifier
1083485551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C.2405783
- Practice address
- 9085 Southern St Ste 220
Orient, OH 43146-9360 - Phone
- (216) 468-5000
- NPI assigned
- Jan 12, 2024
- Last updated
- Jan 23, 2024
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C.2405783 | OH | Primary |
Addresses
Primary practice location
9085 Southern St Ste 220
Orient, OH 43146-9360
Mailing address
9332 Hocking Run
Canal Winchester, OH 43110-7960
Phone (614) 981-0463
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.2405783 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological & Behavioral Consultants, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba LifeStance Health
- Psychiatry Physician
- Beachwood, OH
- NPI 1811915713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1083485551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9332 HOCKING RUN",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431107960",
"telephone_number": "614-981-0463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9085 SOUTHERN ST STE 220",
"city": "ORIENT",
"state": "OH",
"postal_code": "431469360",
"telephone_number": "216-468-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLENBAUGH",
"first_name": "ANGELA",
"middle_name": "M",
"credential": "MS, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-12",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.2405783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orient, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.