Jared Bollenbacher

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60458136 Issued in WA

Practice address

467 Wilson Ave
Columbus, OH 43205-1944

Phone

(260) 615-0021

NPI assigned

Apr 16, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1104446400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 WILSON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051944",
            "telephone_number": "260-615-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 WILSON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051944",
            "telephone_number": "260-615-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLENBACHER",
        "first_name": "JARED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60458136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbb77@uw.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "467 Wilson Ave",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432051944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kura Bolinger, LPC
• Lucinda J Bolinger, LPCC
• Austin Bolker
• Pranav Bollavaram
• Betty Jean Bollenbacher, LSW
• Marissa D Bolles
• Damon Bollin
• McKenna Bollinger
• Darla Annette Bolon, MSW, LISW
• Jenna Boltenhouse

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.