Gerald Bolnick

Individual provider Active NPI Mental Health Counselor · Palm City, FL

NPI 1104133255 · NPPES record last updated Sep 10, 2010

Key facts

NPI
1104133255
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MH 6739 (FL)
Practice address
3577 SW Corporate Pkwy
Palm City, FL 34990-8153
Phone
(772) 220-3439
Fax
(772) 220-3484
NPI assigned
Sep 10, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MH 6739FLMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 6739 FL Yes

Addresses

Primary practice location

3577 SW Corporate Pkwy
Palm City, FL 34990-8153

Mailing address

3577 SW Corporate Pkwy
Palm City, FL 34990-8153
Phone (772) 220-3439

Other providers in Palm City, FL

All providers in Palm City, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.