Lecretia Bolden

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

3622 Prospect Ave E
Cleveland, OH 44115-2704

Phone

(216) 431-4600

NPI assigned

Dec 21, 2018

Last updated

Dec 21, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Imex Inc

  dba KTA MAT & Recovery

  • Occupational Medicine Physician
  • Chesterland, OH
  • NPI 1194229427

  Addiction (Substance Use Disorder)

  NPD (past)
• Moore Counseling & Mediation Services, Inc.

  • Professional Counselor
  • Euclid, OH
  • NPI 1235242280

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1124590633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25151 ZEMAN AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441321806",
            "telephone_number": "216-858-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 PROSPECT AVE E",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152704",
            "telephone_number": "216-431-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "LECRETIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-21",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delena Crystal Bolden
• Eric Bolden Jr.
• Jenoy M Bolden, MSN, APRN, AGACNP-BC
• Lashana Bolden, QMHS
• Lauren Denise Bolden, MD
• Norman Bolden, MD
• Katherine Claire Boldt, LPCC
• Aparna Bole, M.D.
• Raevti Bole, M.D., M.A.
• Mikaela Bolek

• Addiction (Substance Use Disorder) Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; 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.