Individual provider Active NPI

Kaitlin Bolle

  • Addiction (Substance Use Disorder) Counselor
  • Escanaba, MI
National Provider Identifier
1104764695
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1101 Ludington St Ste H
Escanaba, MI 49829-3565
Phone
(906) 789-3528
NPI assigned
Mar 24, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1101 Ludington St Ste H
Escanaba, MI 49829-3565

Mailing address

100 Malton Rd
Negaunee, MI 49866-2001
Phone (906) 228-9699

Other practice location 1

1500 Sandpoint Rd
Munising, MI 49862-1406
Phone (906) 291-3400

Other practice location 2

241 Wright St Bldg 1
Marquette, MI 49855-1955
Phone (906) 228-6545

Other practice location 3

220 Roosevelt St Ste 2
Ironwood, MI 49938-1737
Phone (906) 364-7506

Other practice location 4

1115 S Hemlock St Ste 1
Iron Mountain, MI 49801-3800
Phone (906) 774-2561

Other practice location 5

100 Malton Rd Ste 6
Negaunee, MI 49866-2002
Phone (906) 485-2347

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Recovery Centers Past Accepting new patients
Great Lakes Recovery Centers Past Accepting new patients
Great Lakes Recovery Centers PastSince Feb 6, 2022 Accepting new patients
Great Lakes Recovery Centers PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1104764695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALTON RD",
            "city": "NEGAUNEE",
            "state": "MI",
            "postal_code": "498662001",
            "telephone_number": "906-228-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LUDINGTON ST STE H",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293565",
            "telephone_number": "906-789-3528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Sandpoint Rd",
            "address_purpose": "LOCATION",
            "city": "Munising",
            "state": "MI",
            "postal_code": "498621406",
            "country_code": "US",
            "telephone_number": "906-291-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 Wright St Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498551955",
            "country_code": "US",
            "telephone_number": "906-228-6545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Roosevelt St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Ironwood",
            "state": "MI",
            "postal_code": "499381737",
            "country_code": "US",
            "telephone_number": "906-364-7506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1115 S Hemlock St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498013800",
            "country_code": "US",
            "telephone_number": "906-774-2561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Malton Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Negaunee",
            "state": "MI",
            "postal_code": "498662002",
            "country_code": "US",
            "telephone_number": "906-485-2347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLE",
        "first_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.